Benjamin Zohar, NCACIP

Can You Take Tizanidine With Ibuprofen? Safety, Interactions & Side Effects

Benjamin Zohar, NCACIP -

Quick answer: Tizanidine and ibuprofen may sometimes be used together because they work through different mechanisms, and current tizanidine prescribing information does not list ibuprofen as a specific contraindicated interaction. However, tizanidine can cause sedation, dizziness and low blood pressure, while ibuprofen can cause gastrointestinal bleeding, kidney injury and cardiovascular complications.

Last updated: September 26, 2026.

Safety note: The absence of a specific tizanidine-ibuprofen interaction does not mean the combination is appropriate for everyone. Tizanidine has important interactions with several other medications, including ciprofloxacin and fluvoxamine, and ibuprofen has clinically important gastrointestinal, kidney, cardiovascular and pregnancy-related risks.

Key Takeaways

  • Tizanidine and ibuprofen are different drug classes. Tizanidine is a centrally acting alpha-2 adrenergic agonist used primarily for spasticity, while ibuprofen is a nonsteroidal anti-inflammatory drug, or NSAID.
  • Current tizanidine prescribing information does not list ibuprofen as a specific contraindicated interaction.
  • Tizanidine can cause significant drowsiness, dizziness and low blood pressure. Fainting and bradycardia can occur in susceptible patients.
  • Ciprofloxacin and fluvoxamine are contraindicated with tizanidine because they can substantially increase tizanidine exposure and cause severe hypotension and sedation.
  • Alcohol and other CNS depressants can intensify tizanidine-related sedation.
  • Ibuprofen can cause gastrointestinal bleeding, kidney injury, fluid retention and cardiovascular complications.
  • Clinical trials do not show a consistent additional benefit from adding tizanidine to an NSAID for every case of acute low-back pain.
  • Tizanidine should not necessarily be stopped abruptly after sustained higher-dose use because withdrawal can include rebound hypertension, rapid heart rate and increased muscle tone.

Table of Contents

Can You Take Tizanidine and Ibuprofen Together?

Tizanidine and ibuprofen may sometimes be used together when a clinician determines that both medications are appropriate. Current tizanidine prescribing information does not identify ibuprofen as a specifically contraindicated or named drug interaction.

The medications act through different mechanisms:

  • Tizanidine acts centrally as an alpha-2 adrenergic agonist and reduces muscle tone.
  • Ibuprofen is an NSAID that decreases prostaglandin-mediated pain and inflammation.

That difference means taking the two medications is not simply “doubling up” on the same drug effect.

However, each medication brings its own clinically important risks. A patient who can safely take tizanidine may still have a reason to avoid ibuprofen because of kidney disease, prior gastrointestinal bleeding or cardiovascular disease. Another patient may tolerate ibuprofen but be at increased risk from tizanidine because of low blood pressure, sedation or a major CYP1A2 drug interaction.

For another muscle-relaxant and NSAID interaction guide, see Can You Take Methocarbamol With Ibuprofen? Safety, Side Effects & Risks.

The broader ISSUP interaction pillar is Can You Take Cyclobenzaprine and Ibuprofen Together? Safety, Risks, and What to Know.

Tizanidine vs. Ibuprofen at a Glance

Tizanidine and ibuprofen differ substantially in indication, mechanism and adverse effects. Tizanidine's major practical concerns include sedation and hypotension, while ibuprofen's major concerns include gastrointestinal, kidney and cardiovascular toxicity.

Feature Tizanidine Ibuprofen
Drug class Central alpha-2 adrenergic agonist / skeletal muscle relaxant NSAID
Prescription status Prescription only OTC and prescription strengths
Primary labeled role Management of spasticity Pain, inflammation and fever
Sedation Important and common concern Not a primary drug-class effect
Low blood pressure Can occur Not a typical therapeutic effect
Liver injury Recognized warning Possible but not the defining NSAID toxicity
GI bleeding Not the defining risk Important NSAID risk
Kidney injury Reduced clearance can increase adverse effects in renal impairment NSAIDs can impair renal function
Alcohol concern Additive CNS depression and increased tizanidine exposure Can increase GI bleeding concern, especially with heavy use
Major named interactions Ciprofloxacin, fluvoxamine and other CYP1A2 inhibitors Other NSAIDs, anticoagulants and several renal/cardiovascular medications
Federal controlled substance No No

What Is Tizanidine?

Tizanidine is a centrally acting alpha-2 adrenergic agonist used to manage spasticity. It reduces muscle tone by acting within the central nervous system rather than functioning as an anti-inflammatory or conventional pain medication.

According to the current tizanidine prescribing information, clinically important adverse effects can include:

  • somnolence or drowsiness;
  • dizziness;
  • dry mouth;
  • weakness or fatigue;
  • low blood pressure;
  • slow heart rate;
  • liver-test abnormalities;
  • hallucinations in some patients.

The drug's hypotensive and sedating effects distinguish it from medications such as methocarbamol and cyclobenzaprine and make medication reconciliation particularly important.

Consumer-level information is also available from the National Library of Medicine's MedlinePlus tizanidine guide.

What Is Ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug used to reduce pain, inflammation and fever. It is available in both nonprescription and prescription formulations.

The current ibuprofen prescribing information includes boxed warnings for serious cardiovascular thrombotic events and serious gastrointestinal adverse events including bleeding, ulceration and perforation.

Common reasons people use ibuprofen include:

  • back pain;
  • muscle aches;
  • headache;
  • tooth pain;
  • menstrual pain;
  • arthritis-related pain;
  • fever.

OTC availability does not mean ibuprofen is appropriate for every patient. Risk depends on factors such as dose, duration, age, renal function, cardiovascular disease, gastrointestinal history and concurrent medications.

See the MedlinePlus ibuprofen drug guide for additional patient information.

Do Tizanidine and Ibuprofen Interact?

Current tizanidine prescribing information does not list ibuprofen as a specific contraindicated or named pharmacokinetic interaction. The more important issue is whether either medication presents an independent risk for the individual patient.

Tizanidine risk may be greater in people who:

  • already have low blood pressure;
  • take antihypertensive medication;
  • take sedating medications;
  • use alcohol;
  • have liver disease;
  • have significant kidney impairment;
  • take CYP1A2 inhibitors.

Ibuprofen risk may be greater in people who:

  • have kidney disease;
  • have a history of stomach ulcers;
  • have had gastrointestinal bleeding;
  • have cardiovascular disease;
  • have heart failure;
  • take anticoagulants or antiplatelet medications;
  • take another NSAID;
  • are pregnant.

Clinical Pearl: Tizanidine may lower blood pressure while NSAIDs can sometimes contribute to hypertension, fluid retention or reduced effectiveness of some blood-pressure medications. These effects should never be assumed to “cancel each other out.” Blood-pressure effects are clinically complex and patient-specific.

For comparison, see Can You Take Methocarbamol With Ibuprofen? Safety, Side Effects & Risks, where the main muscle-relaxant concern is sedation rather than tizanidine's additional alpha-2 and CYP1A2 effects.

Can You Take Tizanidine and Ibuprofen at the Same Time?

Current labeling does not establish a universal rule requiring tizanidine and ibuprofen to be separated by a specific number of hours. Whether they should be taken at the same time depends on the actual prescriptions, indication, medical history and other medications.

Factors a clinician or pharmacist may review include:

  • why tizanidine was prescribed;
  • ibuprofen strength and duration;
  • baseline blood pressure;
  • kidney and liver function;
  • history of gastrointestinal bleeding;
  • other sedating drugs;
  • antihypertensive medications;
  • CYP1A2 inhibitors;
  • alcohol use.

Patients should follow their prescription and OTC label instructions rather than creating a new combined schedule from an online timing chart.

Can You Take Tizanidine With Ibuprofen 800 mg?

Ibuprofen 800 mg is a prescription-strength dose, so its use should follow the prescribing clinician's instructions. A lack of a specifically listed tizanidine-ibuprofen interaction does not make high-dose ibuprofen appropriate for every person.

Prescription-strength NSAID use is especially important to review when a patient has:

  • chronic kidney disease;
  • high blood pressure;
  • heart disease;
  • heart failure;
  • previous gastrointestinal bleeding;
  • peptic ulcer disease;
  • anticoagulant treatment;
  • antiplatelet treatment;
  • dehydration;
  • older age;
  • concurrent NSAID use.

The tizanidine prescription should not be interpreted as permission to add prescription-strength ibuprofen independently.

Can Tizanidine Lower Blood Pressure?

Yes. Tizanidine can cause clinically significant hypotension because it is an alpha-2 adrenergic agonist. Orthostatic symptoms and fainting can occur, particularly in susceptible patients or when interacting medications increase tizanidine exposure.

The tizanidine label specifically advises monitoring for hypotension in patients who are also receiving antihypertensive therapy.

Possible signs include:

  • dizziness when standing;
  • lightheadedness;
  • weakness;
  • near-fainting;
  • fainting;
  • unusually slow pulse in some cases.

A person who develops severe dizziness, fainting or marked weakness after taking tizanidine should not simply assume the symptom is ordinary muscle-relaxant drowsiness.

Does Tizanidine Cause Drowsiness or Affect Driving?

Yes. Sedation is one of the best-established adverse effects of tizanidine and can interfere with normal activities.

In controlled multidose trials summarized in current prescribing information, somnolence was reported substantially more often with tizanidine than placebo.

Other CNS effects can include:

  • dizziness;
  • weakness;
  • fatigue;
  • reduced alertness;
  • impaired balance;
  • psychomotor impairment.

Patients should determine how tizanidine affects them before driving, operating machinery or engaging in activities where impaired coordination could cause injury.

For another ISSUP article dealing with medication-related CNS impairment, see ZzzQuil and Alcohol: Risks, Side Effects, and Why Mixing Them Can Be Dangerous.

Can You Drink Alcohol With Tizanidine and Ibuprofen?

Alcohol is an important concern with tizanidine because it can both increase tizanidine exposure and add to its central nervous system depressant effects.

Current tizanidine labeling reports that alcohol increased measured tizanidine exposure and was associated with increased adverse reactions. Alcohol and tizanidine also have additive CNS-depressant effects.

The combination may increase:

  • drowsiness;
  • dizziness;
  • poor balance;
  • impaired judgment;
  • slowed reaction time;
  • risk of falls or accidents.

Alcohol can also worsen concern about ibuprofen-associated gastrointestinal bleeding, particularly with substantial or regular alcohol consumption.

This means alcohol potentially introduces two different safety problems: more tizanidine-related CNS impairment and greater NSAID-related gastrointestinal risk.

See ZzzQuil and Alcohol: Risks, Side Effects, and Why Mixing Them Can Be Dangerous for another example of additive CNS-depressant effects.

What Drugs Have Important Interactions With Tizanidine?

Tizanidine has several clinically important interactions that are more significant than the tizanidine-ibuprofen question itself. Its metabolism through CYP1A2 makes medication reconciliation particularly important.

Ciprofloxacin

Ciprofloxacin is contraindicated with tizanidine. Current prescribing information reports that ciprofloxacin can markedly increase tizanidine exposure, resulting in substantially increased drowsiness, psychomotor impairment and reductions in blood pressure.

Fluvoxamine

Fluvoxamine is also contraindicated with tizanidine. Like ciprofloxacin, it is a potent CYP1A2 inhibitor and can produce clinically important increases in tizanidine exposure.

Other CYP1A2 inhibitors

The tizanidine label also identifies other CYP1A2 inhibitors that may increase the risk of:

  • hypotension;
  • bradycardia;
  • excessive drowsiness.

Examples listed in prescribing information include certain fluoroquinolones, antiarrhythmics, cimetidine, famotidine, acyclovir, ticlopidine and oral contraceptives.

Alcohol and other CNS depressants

Tizanidine's sedative effects can be additive with:

  • alcohol;
  • opioids;
  • benzodiazepines;
  • tricyclic antidepressants;
  • other sedating medications.

Medication-safety priority: Someone asking whether ibuprofen can be taken with tizanidine should still have the rest of the medication list checked. An antibiotic, antidepressant, blood-pressure medication or sedative may represent the more clinically important interaction.

For a broader medication-class overview, see Classification of drugs, UTC for healthcare professionals.

Can Tizanidine Affect the Liver?

Yes. Tizanidine can cause hepatocellular liver injury, and current prescribing information recommends liver-enzyme monitoring in appropriate patients.

The risk deserves particular attention in people with:

  • pre-existing liver disease;
  • abnormal liver tests;
  • other potentially hepatotoxic medications;
  • symptoms suggesting liver injury.

Symptoms that can warrant medical evaluation include:

  • yellowing of the skin or eyes;
  • dark urine;
  • persistent nausea;
  • unusual fatigue;
  • loss of appetite;
  • right-upper-abdominal discomfort.

Ibuprofen also has potential hepatic adverse effects, but gastrointestinal, renal and cardiovascular toxicity are generally the more prominent NSAID safety considerations.

What Are the Kidney and Stomach Risks of Ibuprofen?

Ibuprofen can cause serious kidney and gastrointestinal complications even though lower-dose products are available without a prescription.

The current ibuprofen prescribing information warns about serious gastrointestinal bleeding, ulceration and perforation.

Gastrointestinal risk

Risk may be greater in people who:

  • have had a stomach ulcer;
  • have previously experienced gastrointestinal bleeding;
  • are older;
  • take anticoagulants;
  • take antiplatelet medications;
  • take corticosteroids;
  • use another NSAID;
  • drink substantial amounts of alcohol;
  • use NSAIDs for longer periods.

Kidney risk

NSAIDs may reduce renal blood flow and worsen kidney function in susceptible patients.

Risk can be greater with:

  • existing kidney impairment;
  • dehydration;
  • heart failure;
  • liver disease;
  • older age;
  • diuretic therapy;
  • ACE inhibitors;
  • angiotensin receptor blockers.

Tizanidine also requires additional caution in significant renal impairment because reduced clearance can increase drowsiness, dizziness and other adverse effects.

Can Tizanidine and Ibuprofen Be Used During Pregnancy?

Pregnancy requires individual medical review for both medications, and ibuprofen has a specific FDA warning beginning at approximately 20 weeks of pregnancy.

The FDA recommends avoiding NSAIDs at 20 weeks of pregnancy or later unless specifically advised by a healthcare professional because NSAIDs may cause fetal kidney problems and low amniotic fluid.

Later in pregnancy, additional fetal cardiovascular concerns become relevant.

Tizanidine also requires clinician-directed risk-benefit assessment during pregnancy. Patients should not start, stop or combine these medications during pregnancy based on an online interaction checker alone.

Does Adding Tizanidine to Ibuprofen Improve Back Pain?

Clinical studies have produced mixed results, and newer evidence does not support assuming that adding tizanidine to ibuprofen will improve outcomes for every patient with acute low-back pain.

2019 randomized trial

A 2019 randomized, double-blind trial published in Annals of Emergency Medicine enrolled 320 emergency-department patients with acute nonradicular low-back pain.

All patients received ibuprofen and were randomized to receive placebo, baclofen, metaxalone or tizanidine in addition.

At one week, improvement in functional disability was similar across the groups. The investigators concluded that adding tizanidine, baclofen or metaxalone to ibuprofen did not appear to improve function or pain more than ibuprofen plus placebo.

Older 1988 trial

An earlier double-blind multicenter study of 105 patients compared tizanidine plus ibuprofen with placebo plus ibuprofen for acute low-back pain.

Both groups improved, but the investigators reported earlier improvement in some pain outcomes in the tizanidine group. CNS effects, including drowsiness, were more frequent in patients receiving tizanidine.

Study Population Comparison Main finding
Berry & Hutchinson, 1988 105 patients with acute low-back pain Tizanidine + ibuprofen vs. placebo + ibuprofen Earlier improvement in some outcomes with tizanidine; more CNS adverse effects
Friedman et al., 2019 320 ED patients with acute nonradicular low-back pain Ibuprofen + muscle relaxant vs. ibuprofen + placebo No additional improvement in function or pain at one week with tizanidine

Evidence interpretation: An older positive study and a newer negative trial should not be collapsed into a claim that tizanidine either always improves ibuprofen or never has a role. Patient population, outcome measured, clinical indication, treatment duration and adverse effects all matter.

This is also why the methocarbamol and ibuprofen interaction guide and cyclobenzaprine and ibuprofen guide should be treated as separate pages rather than assuming all muscle relaxants behave the same way.

The same randomized trial also evaluated baclofen with ibuprofen. For the separate renal-clearance, sedation and withdrawal considerations associated with baclofen, see Can You Take Baclofen With Ibuprofen? Safety, Interactions & Side Effects.

Can You Stop Tizanidine Suddenly?

Abrupt discontinuation can cause withdrawal or rebound effects in some patients, particularly after higher-dose or prolonged use.

Current prescribing information identifies possible withdrawal reactions including:

  • rebound high blood pressure;
  • rapid heart rate;
  • increased muscle tone;
  • tremor;
  • anxiety.

Patients taking tizanidine regularly should not independently create a taper or abruptly change their prescription without consulting the prescriber.

This issue is specific to tizanidine and is another reason the medication should not simply be treated as interchangeable with every other “muscle relaxer.”

Tizanidine and Ibuprofen: Myth vs. Fact

Myth Fact
Tizanidine and ibuprofen do the same thing. No. Tizanidine acts centrally to reduce muscle tone, while ibuprofen is an NSAID that reduces pain and inflammation.
If ibuprofen is not listed as an interaction, taking the two is risk-free. No. Each drug carries important independent risks and the patient's other medications may create more serious interactions.
Tizanidine is just a stronger version of ibuprofen. No. They belong to different pharmacologic classes and have very different mechanisms and adverse-effect profiles.
Tizanidine only causes sleepiness. Tizanidine can also cause hypotension, bradycardia, liver injury and other clinically important adverse effects.
Ciprofloxacin is safe because it is only an antibiotic. Ciprofloxacin is contraindicated with tizanidine because it can markedly increase tizanidine exposure and cause severe hypotension and sedation.
Ibuprofen is always safe because it is available over the counter. Ibuprofen can cause GI bleeding, kidney injury and serious cardiovascular adverse events.
You can stop tizanidine whenever you want because it is not a controlled substance. Abrupt cessation after sustained higher-dose treatment can cause rebound hypertension, tachycardia and increased muscle tone.
Adding tizanidine to ibuprofen always improves back pain. Clinical trials have produced mixed findings, and a 2019 randomized trial found no added benefit at one week for acute nonradicular low-back pain.

When to Seek Medical Help

Prompt medical evaluation is appropriate when severe sedation, fainting, significant blood-pressure symptoms, gastrointestinal bleeding, kidney problems or liver-related symptoms occur while using these medications.

Seek urgent or emergency help for symptoms such as:

  • loss of consciousness;
  • difficulty breathing;
  • inability to wake;
  • severe fainting or collapse;
  • very slow heart rate with symptoms;
  • chest pain;
  • sudden weakness or difficulty speaking;
  • vomiting blood;
  • black or tarry stools;
  • severe abdominal pain;
  • markedly reduced urination;
  • yellowing of the skin or eyes;
  • severe allergic reaction.

Patients should contact the prescribing clinician or pharmacist for persistent dizziness, excessive sedation, recurrent low-blood-pressure symptoms, worsening muscle symptoms or questions about combining tizanidine with other medications.

Frequently Asked Questions About Tizanidine and Ibuprofen

Can you take tizanidine and ibuprofen together?

They may sometimes be used together, and current tizanidine prescribing information does not list ibuprofen as a specific contraindicated interaction. However, tizanidine can cause sedation and hypotension, while ibuprofen can cause gastrointestinal, kidney and cardiovascular complications. Other medications and medical conditions may significantly change the safety of the combination.

Can you take Zanaflex and ibuprofen together?

Zanaflex is a brand associated with tizanidine, so this is the same medication-interaction question. A clinician or pharmacist should review the patient's blood pressure, kidney and liver function, gastrointestinal history and complete medication list before assuming the combination is appropriate.

Can you take tizanidine and Advil together?

Advil contains ibuprofen. Current tizanidine labeling does not identify ibuprofen as a specifically contraindicated interaction, but both medicines still carry independent risks. Patients should also avoid accidentally combining Advil with another NSAID-containing medication.

Can you take tizanidine with ibuprofen 800 mg?

Ibuprofen 800 mg is prescription strength and should be used according to a clinician's directions. The lack of a named tizanidine interaction does not mean high-dose ibuprofen is appropriate for everyone, especially patients with kidney disease, ulcers, cardiovascular disease or anticoagulant use.

Do tizanidine and ibuprofen need to be taken hours apart?

Current labeling does not specify a universal separation interval between the two medications. Timing should follow the actual prescription and OTC instructions rather than a general online schedule. A pharmacist can evaluate the specific formulation, dose and other medicines being taken.

Does tizanidine make you sleepy?

Yes. Drowsiness and sedation are well-recognized tizanidine effects and may interfere with normal daily activities, driving and coordination. Alcohol, opioids, benzodiazepines and other CNS depressants can increase this impairment.

Can tizanidine make your blood pressure too low?

Yes. Tizanidine is an alpha-2 adrenergic agonist and can cause hypotension, orthostatic symptoms and fainting. Risk can increase with antihypertensive medications or drugs that substantially increase tizanidine concentrations.

Why can't tizanidine be taken with ciprofloxacin?

Ciprofloxacin inhibits CYP1A2, an important pathway involved in tizanidine metabolism. The combination can greatly increase tizanidine exposure and has been associated with pronounced reductions in blood pressure, increased drowsiness and psychomotor impairment. Current prescribing information lists the combination as contraindicated.

Can you drink alcohol while taking tizanidine?

Alcohol can increase tizanidine exposure and has additive CNS-depressant effects with the medication. This can worsen sedation, dizziness and impaired coordination. When ibuprofen is also being used, substantial alcohol intake can additionally increase concern about gastrointestinal bleeding.

For more information on alcohol-related medication interactions, see ZzzQuil and Alcohol: Risks, Side Effects, and Why Mixing Them Can Be Dangerous.

Is ibuprofen a muscle relaxer?

No. Ibuprofen is an NSAID. It reduces pain and inflammation but is not classified as a skeletal muscle relaxant. Tizanidine has a different central mechanism and is used primarily for the management of spasticity.

Can you take naproxen and ibuprofen with tizanidine?

Ibuprofen and naproxen are both NSAIDs. Combining them can increase gastrointestinal and kidney risk and generally should not be done unless specifically directed by a healthcare professional. Tizanidine does not make combining two NSAIDs safer.

Can tizanidine affect the liver?

Yes. Current prescribing information warns that tizanidine can cause hepatocellular liver injury. Patients with liver disease or symptoms suggesting liver injury require additional medical assessment, and liver-function monitoring may be appropriate during treatment.

Can tizanidine be stopped suddenly?

Stopping tizanidine abruptly after prolonged or higher-dose treatment can cause rebound hypertension, rapid heart rate and increased muscle tone. Patients taking it regularly should discuss discontinuation with their prescriber rather than developing their own tapering schedule.

Is tizanidine better than methocarbamol with ibuprofen?

Neither combination is universally better. Tizanidine and methocarbamol have different indications, mechanisms, adverse effects and interaction profiles. Tizanidine has particularly important hypotension and CYP1A2 interaction concerns. See Can You Take Methocarbamol With Ibuprofen? Safety, Side Effects & Risks for the separate comparison.

Source Verification

This article was checked against current U.S. prescribing information for tizanidine and ibuprofen, FDA NSAID pregnancy guidance, National Library of Medicine drug information and peer-reviewed clinical trials.

The interaction discussion distinguishes the absence of a specifically listed tizanidine-ibuprofen interaction from the clinically important independent risks of each medication. Tizanidine's named CYP1A2 interactions, hypotension, sedation, liver-injury warning and withdrawal reactions are treated separately from ibuprofen's gastrointestinal, renal and cardiovascular risks.

The efficacy section includes both an older controlled study reporting earlier improvement with tizanidine plus ibuprofen and a newer randomized trial that found no additional one-week benefit when tizanidine was added to ibuprofen for acute nonradicular low-back pain. The differing findings are presented rather than selecting one study as universally applicable.

References

  1. U.S. National Library of Medicine, DailyMed. Tizanidine Hydrochloride Tablets: Prescribing Information .
  2. U.S. National Library of Medicine, DailyMed. Ibuprofen Tablets: Prescribing Information .
  3. U.S. National Library of Medicine, MedlinePlus. Tizanidine: Drug Information .
  4. U.S. National Library of Medicine, MedlinePlus. Ibuprofen: Drug Information .
  5. U.S. Food and Drug Administration. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Avoid Use in Pregnancy at 20 Weeks or Later .
  6. Friedman BW, Irizarry E, Solorzano C, et al. A Randomized, Placebo-Controlled Trial of Ibuprofen Plus Metaxalone, Tizanidine, or Baclofen for Acute Low Back Pain . Annals of Emergency Medicine. 2019;74(4):512-520.
  7. Berry H, Hutchinson DR. Tizanidine and Ibuprofen in Acute Low-Back Pain: Results of a Double-Blind Multicentre Study in General Practice . Journal of International Medical Research. 1988;16(2):83-91.
  8. Hung KKC, Lam RPK, Lee HKH, et al. Comparison of Diclofenac With Tramadol, Tizanidine or Placebo in the Treatment of Acute Low Back Pain and Sciatica: Multi-Center Randomized Controlled Trial . Postgraduate Medical Journal. 2024.

Last updated: September 26, 2026.

About the Author

Benjamin Zohar, NCACIP is a Nationally Certified Advanced Clinical Intervention Professional and ISSUP network moderator specializing in addiction intervention, treatment navigation and emerging substance-use risks. His educational work published through ISSUP on counterfeit medications, fentanyl exposure and concentrated 7-hydroxymitragynine has been cited or referenced by GoodRx, The Washington Post, WIRED and Newsweek.

Medical review: Brandon McNally, RN

Medical disclaimer: This article is intended for educational and public-health purposes. It does not provide individualized medical advice, diagnosis or a tapering schedule. Do not start, stop or alter a prescription medication without consulting a qualified healthcare professional. Call emergency services for seizures, difficulty breathing, loss of consciousness, severe confusion or other life-threatening symptoms.

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