Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Tizanidine

Skeletal muscle relaxant (alpha-2 agonist)

Brand names: Zanaflex

Oral health effects

  • Xerostomia (dry mouth)

    Dry mouth is one of the most common side effects.

    Clinical management: Hydration, salivary substitutes, high-fluoride caries prevention.

  • Dizziness on standing (orthostatic hypotension)

    Tizanidine is an alpha-2 agonist that lowers blood pressure (label warning); in a dose study hypotension occurred in 16–33% at 8–16 mg, and syncope has been reported. Levels rise sharply with CYP1A2 inhibitors such as ciprofloxacin (contraindicated).

    Clinical management: Raise the chair slowly at the end of the appointment and have the patient sit upright for a minute or two before standing; steady them as they get up. Ask about dizziness on standing, especially after dose changes or in older patients. Avoid prescribing ciprofloxacin to patients taking tizanidine.

Sources

  1. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
  2. Tizanidine prescribing information (FDA label) Asclemed USA, Inc. / DailyMed, 2025.