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Cyclobenzaprine vs. Zanaflex (tizanidine): Muscle Relaxer Side Effects

Cyclobenzaprine vs. Zanaflex: What’s the difference?

What is cyclobenzaprine? What is Zanaflex?

Cyclobenzaprine is a muscle relaxant used with rest and physical therapy for short-term relief (up to two to three weeks) of muscle spasms associated with acute painful muscle and skeletal conditions. Cyclobenzaprine relieves muscle spasm when the spasm that results from local problems in the muscle itself and not from the nerves controlling the muscles. Cyclobenzaprine accomplishes its helpful effect through a complex mechanism within the nervous system, most likely in the brainstem.

Zanaflex (tizanidine) is a skeletal muscle relaxant used for the treatment and management of skeletal muscle spasticity, typically resulting from neurological problems. Spasticity may be due to multiple sclerosis or spinal cord injury. It works on alpha 2 receptors in the central nervous system (brain and spinal cord) and blocks nerve impulses from reaching muscles, which produces muscle relaxation.

What are the side effects of cyclobenzaprine and Zanaflex?


The most common side effects of cyclobenzaprine include:

Other reported side effects include:

Possible serious side effects include:

Abrupt cessation after prolonged therapy may cause withdrawal symptoms such as headaches, nausea, and weakness.


Common side effects of tizanidine include:

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What is the dosage of cyclobenzaprine vs. Zanaflex?


The recommended dose of cyclobenzaprine dose is 5 or 10 mg three times daily using immediate release tablets or 15 or 30 mg once daily using extended release tablets.


Initially take 2 – 4 mg by mouth every 6 to 8 hours for up to 3 doses in 24 hours. Increase by 2 to 4 mg until satisfactory response is achieved; however, the maximum dose is 36 mg per day.

What drugs interact with cyclobenzaprine and Zanaflex?



Tizanidine should not be used with:

These medications can slow down the breakdown of tizanidine and lead to increased sedation, drowsiness and slowed reflexes.

Tizanidine should be used with caution with medications like:

These medications can further increase the side effects of tizanidine.

Are cyclobenzaprine and Zanaflex safe to use while pregnant or breastfeeding?


There are no adequate studies of cyclobenzaprine in pregnant women. However, studies in animals suggest no important effects on the fetus. Cyclobenzaprine therefore can be used in pregnancy if the physician feels that it is necessary.

It is not known whether cyclobenzaprine is secreted in milk. However, since it is related to the tricyclic antidepressants, some of which are excreted in breast milk, caution is advised in using this medication in women who are breastfeeding.


There are no adequate studies done on tizanidine to determine safe and effective use in pregnant women.

It is not known whether tizanidine enters human milk. Because it is soluble in lipids, it might pass into breast milk.


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