Zanaflex (tizanidine) from Acorda Therapeutics is a short-acting drug used to manage spasticity associated with multiple sclerosis and spinal cord injury. It blocks nerve impulses (pain sensations) that are sent to the brain. Because of its temporary effect, treatment with tizanidine should be reserved for moments when spasticity relief is most important.

Its mechanism of action leads to spasticity reduction by blocking nerve impulses through pre-synaptic inhibition of motor neurons — without reducing muscle strength.

Tizanidine tablets or capsules should be taken by mouth with an initial dosage of 2 mg three times a day. For maintenance, a 2 to 4 mg increase may be prescribed at each dose until satisfactory reduction of muscle spasms is achieved — up to a maximum dose of 36 mg per day.

Most common side effects may include dry mouth, drowsiness, dizziness, asthenia, or infection.

Significant interactions can occur with tizanidine and other medicines, nutritional supplements, and certain herbal products. Patients should confer with their healthcare provider to ensure safe use.

Zanaflex is  available as a generic medicine. The generic is sold at lower prices than the brand name product.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Move It or Lose It: Movement Is Crucial to Well-being with MS

A well-known mantra exists in the multiple sclerosis (MS) community. I first heard it after my diagnosis and have since adopted it as my own. “Move it or lose it.” Movement is essential for everyone’s health and well-being. For those of us with multiple sclerosis, it is imperative. Regular activity will help to strengthen the […]

MS News that Caught My Eye Last Week: A Cure for MS?, MS App, Robot for Balance, Botox for Spasticity

All of the stories in this week’s column come from the recently held Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) forum, held Feb. 28 to March 2 in Dallas, Texas. #ACTRIMS2019 – Forum Leaders Discuss: ‘Will There Be a Cure for MS?’ A reporter for MS News Today asked this question, but the answers […]

#ACTRIMS2019 – Botox Earns High Marks from Patients, Physicians as Treatment for Spasticity, ASPIRE Follow-up Finds

Patients with a range of diseases and disorders, including multiple sclerosis (MS), report high satisfaction with botulinum toxin — also known as Botox  — as a treatment for spasticity, results from the ASPIRE clinical trial show.

The data were presented last week by Daniel S. Bandari, MD, from the MS Center of California & Research Group at the Hoag Neurosciences Institute, at the 4th Annual Americas Committee for Treatment and Research in Multiple Sclerosis Forum in Dallas, Texas. His poster was titled “Individualized OnabotulinumtoxinA Treatment for Spasticity in Multiple Sclerosis Resulted in High Patient and Clinician Satisfaction: The Aspire Study.”

Botox is approved by the U.S. Food and Drug Administration (FDA) to treat muscle spasms, spasticity, and bladder symptoms in patients with a spectrum of diseases, including MS. It is estimated that six to nine of every 10 MS patients experience spasticity at some point.

In collaboration with developer Allergan, an international team of researchers examined real-world data on the effectiveness of Botox to treat spasticity in a study called ASPIRE (NCT01930786). Researchers also assessed both patient and clinician satisfaction with the treatment.

The ASPIRE trial is a prospective, international, multicenter, observational study in centers across North America, Europe, and Asia, that examined 730 adult patients (average age 53.6 years) with spasticity symptoms. In this patient group, the most common diseases were stroke (56%), followed by MS (16%).

Of the initial patients, 397 (54%) completed a two-year follow-up period.

Researchers observed a wide range of injections in upper and lower limbs. Anatomical location and electromyogram (EMG) localization were the most frequently used injection guiding methods in upper and lower limbs, respectively.

In MS patients, the most common treated upper limb spasticity presentation was flexed elbow; the most common lower limb presentation treated was equinovarus foot (in which one or both feet are rotated inward and downward).

Overall, clinicians and patients were satisfied with the effectiveness of Botox in easing spasticity symptoms.

“The majority of patients and clinicians were satisfied that onabotulinumtoxinA treatment improved the patient’s ability to participate in therapy/exercise” Bandari said, specifying 72% of the patients and 91% of the clinicians.

Furthermore, Bandari added, “the majority of patients and clinicians also indicated that they would continue to use onabotulinumtoxinA treatment for spasticity” after the study’s end, specifically 92% of the patients and 98% of clinicians.

Regarding safety, 261 of the initial 730 patients (35.8%), reported 831 adverse side effects. Of these, 23 were considered treatment-related. The most common treatment-related side effect was muscular weakness.

Overall, the team concluded that the results “add to the body of evidence on the safety and effectiveness of onabotulinumtoxinA for the treatment of spasticity.”

Bandari also emphasized that “ASPIRE provides valuable, real-world data … which may help guide clinical strategies.” It also “captured the individualized nature of onabotulinumtoxinA utilization for spasticity in MS patients, while consistently demonstrating high satisfaction among patients and clinicians.”

Axim Improves Delivery of Cannabinoids in Chewing Gums

Axim Biotechnologies announced that it has succeeded in microencapsulating cannabinoids (chemical compounds in cannabis) into the company’s patented chewing gums, which are used to treat several disease symptoms, including pain and spasticity associated with multiple sclerosis (MS). Since the active cannabinoids are degradable in the body, the company needed to find a more stable and bioavailable delivery […]

FDA Asked to Place Cannabis-based Therapy for Progressive MS on Fast Track, MMJ Holdings Says

A request for a potential cannabis-based treatment for multiple sclerosis to be given Fast Track designation, speeding its development as it readies to enter clinical testing, is now before the U.S. Food and Drug Administration (FDA), MMJ International Holdings announced. MMJ-001, as this lead candidate is known, aims to treat the spasticity (muscle stiffness) associated with progressive multiple sclerosis. The company is also targeting Huntington’s-associated chorea, […]

Direct Nerve Stimulation Using MyoRegulator System Seen to Reduce Spasticity in Mice with Spinal Injury

Treatment with PathMaker Neurosystems’ anodal trans‐spinal direct current stimulation (tsDCS), a non-invasive direct nerve stimulation tool called MyoRegulator, was found to effectively ease spasticity in mice with spinal cord injury, a study reports. A link between the ability to control muscle contraction and the levels of a specific neuronal transporter was also identified by its researchers, a […]

Controlling Spasticity Would Greatly Improve Everyday Quality of Life, Survey Shows

An international survey of caregivers and adults with neurological diseases, including multiple sclerosis (MS), revealed that spasticity is a hidden burden, having a negative effect on the ability to perform everyday tasks, and that relieving its symptoms significantly improves patients’ quality of life. The survey was presented by Ipsen, a global biopharmaceutical group, at the […]

MS News that Caught My Eye Last Week: Stimulator for Spasticity, Tysabri Dosing Trial, Mobility Devices Contest, Stem Cell Phase 2 Trial

WeHealth, PathMaker Collaborating to Develop MyoRegulator as Noninvasive Treatment for Spasticity I’m one of the many people with multiple sclerosis (MS) for whom spasticity is a significant problem. This is a nonmedicinal approach to dealing with it. I hope it doesn’t take too long to make this electrical stimulator available and, once it is, that […]

WeHealth, PathMaker Collaborating to Develop MyoRegulator as Noninvasive Treatment for Spasticity

WeHealth by Servier and PathMaker Neurosystems have established a new partnership to develop and commercialize the first neuromodulation technology for noninvasive treatment of spasticity, the companies announced. The agreement establishes an exclusive worldwide distribution arrangement, except for the U.S. and Japan, for PathMaker’s MyoRegulator. The MyoRegulator uses two pairs of disposable skin-surface electrodes that deliver synchronized stimulation […]