Is tizanidine a controlled substance?

In this article:

• What is tizanidine?
• Is tizanidine a controlled substance?
• What does that mean for me?
• What can I take instead of tizanidine?

In this article

• What is tizanidine?
• Is tizanidine a controlled substance?
• What does that mean for me?
• What can I take instead of tizanidine?

Tizanidine, often referred to by its brand name Zanaflex, is a muscle relaxant that is commonly prescribed to manage spasticity. Spasticity is a condition where muscles are stiff or tight, which prevents fluid from moving normally. It causes the muscles to remain in a contracted state, and can affect speech and movement, including the way you walk. Spasticity is usually due to damage to the part of the brain and spinal cord that control muscle and stretch reflexes, and it affects people with conditions such as brain or spinal cord injury, cerebral palsy, or multiple sclerosis (MS). If you are taking or considering taking tizanidine (tizanidine hydrochloride), you may be concerned about addiction and want to know if it is a controlled substance. While tizanidine is not a controlled substance, there are still some precautions to be aware of. Continue reading to learn more about this medicine.

What is tizanidine?

Tizanidine is classified as a muscle relaxant, or more specifically, a central alpha-2-adrenergic agonist. Tizanidine does not work directly on the muscles. It works in the brain and nervous system, slowing activity, and allowing muscles to relax. 

Tizanidine was approved by the United States Food and Drug Administration in 1996 and is approved to treat spasticity. 

Tizanidine is available in the following forms:

• Oral capsules: 2 mg, 4 mg, and 6 mg
• Oral tablets: 2 mg, 4 mg 

Related: Tizanidine dosage

Skeletal muscle relaxants are grouped into two main categories—antispasticity and antispasmodic medicines. 

• Antispasticity medicines work on the spinal cord or skeletal muscles to improve muscle stiffness and spasms, and are used for conditions like cerebral palsy, MS, and spinal cord injuries. Examples include baclofen and dantrolene. 
• Antispasmodic medicines affect central nervous system activity and are prescribed for conditions like lower back pain or muscle spasms. Examples include cyclobenzaprine, metaxalone, and Soma (carisoprodol). 

Some muscle relaxants, including tizanidine as well as Valium (diazepam), fall into both categories. 

While some muscle relaxants are controlled substances, such as Valium and Soma, tizanidine is not a controlled substance. 

Is tizanidine a controlled substance?

Tizanidine is a prescription drug, but is not classified as a controlled substance or narcotic. 

Controlled substances are designated by the U.S. Drug Enforcement Administration (DEA), based on the potential for abuse and dependence. 

For reference, although tizanidine is not categorized as a controlled substance, the following information outlines controlled substance scheduling.

• Schedule I drugs have no accepted medical use, and a high potential for abuse. Some examples include heroin and LSD.
• Schedule II drugs have a high potential for abuse and dependence, and are considered dangerous. Some examples of Schedule II drugs include oxycodone, hydrocodone/acetaminophen, and Ritalin (methylphenidate).
• Schedule III drugs have a moderate to low potential for dependence. They have a lower potential for abuse than Schedule I and II drugs, but a higher potential than Schedule IV drugs. Some examples include Tylenol with codeine and testosterone.
• Schedule IV drugs have a lower potential for abuse and dependence and include drugs such as Xanax (alprazolam), Soma (carisoprodol), Valium (diazepam), Ambien (zolpidem), and others. 
• Schedule V drugs have a lower potential for abuse than Schedule IV drugs, and are generally used to treat diarrhea, cough, or pain. Some examples include Lomotil (diphenoxylate/atropine) and Robitussin AC (guaifenesin/codeine). 

Does tizanidine show up on drug tests?

In most cases, tizanidine would not show up on a drug test. 

Drug tests typically look for things like alcohol, amphetamines, opioids, and benzodiazepines (note that benzodiazepines such as diazepam, which are often used for anxiety, are sometimes used for muscle relaxant purposes). 

Because tests and testing methods vary, if you are taking a drug test, you can tell the lab staff that you are taking tizanidine. 

What does that mean for me?

Tizanidine is not a controlled substance, but there are still potential side effects and risks associated with this medicine. Some of the common side effects of tizanidine include extreme drowsiness, weakness, and dizziness, which are also common side effects of various controlled substances. You should not drive or operate machinery until you know how tizanidine affects you. 

Tizanidine causes central nervous system (CNS) depression (a slowing down of brain activity, which can cause sedation and affect breathing), and should be avoided in combination with other substances or drugs that cause CNS depression. It is advisable to avoid alcohol, as alcohol can intensify these effects. It is important to consult your doctor for medical advice regarding drug interactions, as many other medications (such as medications for anxiety, sleep, or pain) cause CNS depression and can also worsen side effects of tizanidine. Before you take tizanidine, make sure your healthcare provider is aware of all the medications you take—including prescription and OTC drugs, vitamins, and supplements. Do not start any new medicines while taking tizanidine unless approved by your healthcare provider. 

Medical professionals should always be aware of any health conditions you have. Patients with certain medical conditions, like kidney or liver problems, generally require lower doses of tizanidine to reduce the risk of side effects and toxicity.

You should not stop taking tizanidine abruptly, as doing so can cause withdrawal symptoms, including high blood pressure, fast heart rate, and extremely stiff muscles. If you plan to stop taking tizanidine, your healthcare professional can provide a tapering schedule to help you stop the medicine slowly and safely. 

What can I take instead of tizanidine?

If you are interested in exploring alternatives to tizanidine, there are various options to consider. The table below compares tizanidine with some alternative prescription medications. Always discuss your treatment plan with your healthcare provider.