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Tizanidine Hydrochloride side effects: what 17,963 FDA adverse event reports show

Tizanidine Hydrochloride · 1,148 reaction terms · 89,434 drug–reaction co-reports · data 2026-09-14
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Drug class

Central alpha-2-adrenergic agonist

FDA label, Indications wording

Who reports

17,963 reports · 59% serious · 890 with death outcome · 79% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Tizanidine Tablets, USP is a central alpha-2-adrenergic agonist indicated for the management of spasticity. Because of the short duration of therapeutic effect, treatment with Tizanidine Tablets, USP should be reserved for those daily activities and times when relief of spasticity is most important .

FDA label, Indications and Usage

What it is

Tizanidine Tablets, USP (tizanidine hydrochloride) is a central alpha 2 -adrenergic agonist. Tizanidine HCl is a white to off-white, fine crystalline powder, which is odorless or with a faint characteristic odor. Tizanidine is slightly soluble in water and methanol; solubility in water decreases as the pH increases.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 2Reporting / coding artifact 2Not in label — unassessed 36
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,108 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Myofascial pain syndrome2237.1
24.2–56.6ROR 37.1 · calibrated p 2e-4 ✓
35.0 EB05 24.3 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=21not reported in cached trials
Lumbar radiculopathy2929.7
20.5–42.9ROR 29.7 · calibrated p 4e-4 ✓
28.5 EB05 20.8 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=28not reported in cached trials
Cervical radiculopathy1728.3
17.5–45.7ROR 28.3 · calibrated p 7e-4 ✓
26.9 EB05 17.7 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Chronic kidney disease-mineral and bone disorder2325.5
16.9–38.5ROR 25.5 · calibrated p 1e-3 ✓
24.5 EB05 17.2 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=23not reported in cached trials
Infusion site discharge3322.9
16.3–32.4ROR 23.0 · calibrated p 0.001 ✓
22.3 EB05 16.6 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=28 · 79% consumernot reported in cached trials
Infusion site bruising3117.2
12.1–24.6ROR 17.3 · calibrated p 0.005 ✓
16.8 EB05 12.3 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=27not reported in cached trials
Neurogenic bladder2916.2
11.2–23.3ROR 16.2 · calibrated p 0.007 ✓
15.7 EB05 11.3 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=28not reported in cached trials
Obstructive sleep apnoea syndrome1916.1
10.2–25.3ROR 16.1 · calibrated p 0.008 ✓
15.3 EB05 10.0 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=18not reported in cached trials
Pre-existing condition improved8515.9
12.9–19.7ROR 16.0 · calibrated p 0.006 ✓
15.6 EB05 13.0 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=52not reported in cached trials
Product administration interrupted9414.5
11.8–17.7ROR 14.5 · calibrated p 0.009 ✓
14.2 EB05 11.9 · IC025 +3.4
3/3 methods agree
Reporting / coding artifactserious n=83not reported in cached trials
Complex regional pain syndrome1814.3
9.0–22.7ROR 14.3 · calibrated p 0.012 ✓
13.4 EB05 8.4 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Infusion site pruritus3613.6
9.8–18.9ROR 13.6 · calibrated p 0.012 ✓
13.2 EB05 9.7 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=28NCT01839279: 5/72 (6.9%) on Tizanidine Hydrochloride; 1/32 (3.1%) control
Paraplegia3112.7
8.9–18.0ROR 12.7 · calibrated p 0.017 ✓
12.1 EB05 8.6 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=31not reported in cached trials
Hyperparathyroidism secondary2712.6
8.6–18.4ROR 12.6 · calibrated p 0.018 ✓
11.9 EB05 8.3 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=27not reported in cached trials
Haemorrhagic diathesis3812.5
9.1–17.2ROR 12.6 · calibrated p 0.017 ✓
12.0 EB05 9.0 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=36 · ♀ 100% (drug 79%)not reported in cached trials
Nephrogenic anaemia4912.4
9.3–16.4ROR 12.4 · calibrated p 0.017 ✓
12.0 EB05 9.3 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=49not reported in cached trials
Bladder spasm1912.0
7.7–18.9ROR 12.0 · calibrated p 0.022 ✓
11.0 EB05 7.0 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Drug screen negative1812.0
7.6–19.1ROR 12.0 · calibrated p 0.023 ✓
10.9 EB05 6.8 · IC025 +2.4
3/3 methods agree
Reporting / coding artifact–not reported in cached trials
Cervical spinal stenosis1711.6
7.2–18.7ROR 11.6 · calibrated p 0.026 ✓
10.3 EB05 6.4 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious n=17not reported in cached trials
Pneumonia aspiration23911.3
9.9–12.8ROR 11.4 · calibrated p 0.021 ✓
11.1 EB05 10.0 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious PRR 11.0not reported in cached trials
Infusion site haemorrhage3111.3
7.9–16.0ROR 11.3 · calibrated p 0.025 ✓
10.6 EB05 7.6 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=25 · 100% consumernot reported in cached trials
Arthritis infective4310.9
8.1–14.7ROR 10.9 · calibrated p 0.027 ✓
10.4 EB05 7.9 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=42 · ♀ 100% (drug 79%)not reported in cached trials
Dysphoria4710.9
8.2–14.5ROR 10.9 · calibrated p 0.027 ✓
10.4 EB05 8.0 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=46not reported in cached trials
Chronic inflammatory demyelinating polyradiculoneuropathy1310.8
6.2–18.6ROR 10.8 · calibrated p 0.036 ✓
9.1 EB05 5.2 · IC025 +2.0
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Spinal fusion surgery3610.5
7.6–14.6ROR 10.6 · calibrated p 0.031 ✓
9.9 EB05 7.3 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=35 · ♀ 56% (drug 79%)not reported in cached trials
Intervertebral disc degeneration8310.5
8.5–13.0ROR 10.5 · calibrated p 0.029 ✓
10.2 EB05 8.4 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious PRR 10.9not reported in cached trials
Cartilage injury2210.5
6.9–15.9ROR 10.5 · calibrated p 0.034 ✓
9.5 EB05 6.3 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious n=21 · 70% consumernot reported in cached trials
Cystitis interstitial1410.3
6.1–17.3ROR 10.3 · calibrated p 0.041 ✓
8.7 EB05 5.1 · IC025 +2.0
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Lumbar spinal stenosis2510.0
6.8–14.9ROR 10.0 · calibrated p 0.038 ✓
9.1 EB05 6.3 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious n=25 · ♀ 56% (drug 79%)not reported in cached trials
Essential hypertension2210.0
6.6–15.2ROR 10.0 · calibrated p 0.040 ✓
9.0 EB05 6.0 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious n=21not reported in cached trials
Infusion site swelling529.9
7.6–13.0ROR 10.0 · calibrated p 0.036 ✓
9.5 EB05 7.4 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=41not reported in cached trials
Intervertebral disc disorder369.9
7.1–13.7ROR 9.9 · calibrated p 0.038 ✓
9.2 EB05 6.8 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=35not reported in cached trials
Spinal osteoarthritis739.7
7.7–12.2ROR 9.8 · calibrated p 0.037 ✓
9.4 EB05 7.6 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious PRR 9.6not reported in cached trials
Acute sinusitis149.6
5.7–16.2ROR 9.6 · calibrated p 0.051
8.0 EB05 4.8 · IC025 +2.0
3/3 methods agree
Not in label — unassessedserious n=14not reported in cached trials
Narcolepsy159.3
5.6–15.5ROR 9.4 · calibrated p 0.053
7.9 EB05 4.8 · IC025 +2.0
3/3 methods agree
Not in label — unassessedserious n=14not reported in cached trials
Multiple allergies629.3
7.2–11.9ROR 9.3 · calibrated p 0.044 ✓
8.9 EB05 7.1 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=52 · 73% consumernot reported in cached trials
Facial bones fracture289.0
6.2–13.1ROR 9.0 · calibrated p 0.053
8.2 EB05 5.8 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious n=28 · ♀ 54% (drug 79%)not reported in cached trials
Fibula fracture228.9
5.9–13.5ROR 8.9 · calibrated p 0.057
7.9 EB05 5.3 · IC025 +2.2
3/3 methods agree
Not in label — unassessedserious n=22 · ♀ 100% (drug 79%)not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Tizanidine Hydrochloride as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (1 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Fatigue (tiredness)1,5182.3
2.2–2.4ROR 2.4 · calibrated p 0.856
2.3 EB05 2.2 · IC025 +1.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.6NCT01839279: 13/72 (18.1%) on Tizanidine Hydrochloride; 1/32 (3.1%) control
Nausea1,4522.1
2.0–2.3ROR 2.3 · calibrated p 0.926
2.1 EB05 2.1 · IC025 +1.0
3/3 methods agree
Not in label — unassessedserious PRR 2.4NCT01839279: 9/72 (12.5%) on Tizanidine Hydrochloride; 4/32 (12.5%) control
Pain1,4512.8
2.6–2.9ROR 2.9 · calibrated p 0.656
2.8 EB05 2.6 · IC025 +1.4
3/3 methods agree
Not in label — unassessedserious PRR 2.8NCT01839279: 4/72 (5.6%) on Tizanidine Hydrochloride; 2/32 (6.2%) control
Headache1,4082.6
2.5–2.8ROR 2.8 · calibrated p 0.707
2.6 EB05 2.5 · IC025 +1.3
3/3 methods agree
Not in label — unassessedserious PRR 3.1NCT01839279: 10/72 (13.9%) on Tizanidine Hydrochloride; 5/32 (15.6%) control
Drug ineffective (drug did not work)1,2471.1
1.0–1.2ROR 1.1 · calibrated p 0.382
1.1 EB05 1.1 · IC025 +0.1Reporting / coding artifactserious PRR 1.4not reported in cached trials
Fall1,0303.6
3.4–3.8ROR 3.8 · calibrated p 0.421
3.6 EB05 3.4 · IC025 +1.7
3/3 methods agree
Not in label — unassessedserious PRR 3.4not reported in cached trials
Dizziness9262.2
2.0–2.3ROR 2.2 · calibrated p 0.934
2.2 EB05 2.1 · IC025 +1.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.4NCT03068897: 2/80 (2.5%) on Tizanidine Hydrochloride
Diarrhoea (diarrhea)8811.6
1.5–1.7ROR 1.6 · calibrated p 0.726
1.6 EB05 1.5 · IC025 +0.6Not in label — unassessedserious PRR 1.7not reported in cached trials
Dyspnoea (shortness of breath)8781.8
1.7–1.9ROR 1.9 · calibrated p 0.862
1.8 EB05 1.7 · IC025 +0.7Not in label — unassessedserious PRR 1.8not reported in cached trials
Arthralgia (joint pain)8092.3
2.1–2.4ROR 2.3 · calibrated p 0.884
2.3 EB05 2.1 · IC025 +1.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.7not reported in cached trials
Vomiting7761.9
1.8–2.1ROR 2.0 · calibrated p 0.930
1.9 EB05 1.8 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 2.0not reported in cached trials
Depression7703.9
3.7–4.2ROR 4.1 · calibrated p 0.365
3.9 EB05 3.7 · IC025 +1.9
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.3not reported in cached trials
Asthenia (weakness)7652.4
2.2–2.5ROR 2.4 · calibrated p 0.840
2.4 EB05 2.2 · IC025 +1.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.5not reported in cached trials
Back pain7353.7
3.4–4.0ROR 3.8 · calibrated p 0.415
3.7 EB05 3.5 · IC025 +1.8
3/3 methods agree
Not in label — unassessedserious PRR 4.3NCT01839279: 4/72 (5.6%) on Tizanidine Hydrochloride; 2/32 (6.2%) control
Anxiety6892.8
2.6–3.0ROR 2.9 · calibrated p 0.662
2.8 EB05 2.6 · IC025 +1.4
3/3 methods agree
Not in label — unassessedserious PRR 3.2not reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Tizanidine ↔ Hypotension.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Tizanidine Hydrochloride?

In FDA FAERS, the most frequently co-reported reaction terms for Tizanidine Hydrochloride are fatigue, nausea, pain, headache, fall, dizziness. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Tizanidine Hydrochloride have an FDA boxed warning?

No. The FDA label retrieved for Tizanidine Hydrochloride has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Tizanidine Hydrochloride causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.