When Your Tizanidine Prescription Can't Be Filled

Whether your pharmacy is out of stock, you're experiencing side effects, or your insurance has changed, there are times when you may need an alternative to Tizanidine. The good news is that several effective muscle relaxants exist — and your doctor can help you find one that works for your situation.

This guide covers what Tizanidine does, how it works, and the most commonly prescribed alternatives so you can have an informed conversation with your healthcare provider.

What Is Tizanidine?

Tizanidine (brand name Zanaflex) is a centrally acting muscle relaxant prescribed primarily for spasticity — the involuntary muscle tightness and stiffness associated with conditions like multiple sclerosis, spinal cord injuries, stroke, and traumatic brain injuries. It's also used off-label for chronic pain, migraines, and musculoskeletal pain syndromes.

Tizanidine is available as tablets (2 mg and 4 mg) and capsules (2 mg, 4 mg, and 6 mg), taken up to three times daily with a maximum dose of 36 mg per day. For more details, see our full guide on what Tizanidine is, its uses, and dosage.

How Does Tizanidine Work?

Tizanidine is an alpha-2 adrenergic receptor agonist. It works in the central nervous system by reducing the release of excitatory neurotransmitters (glutamate and aspartate) from spinal interneurons. This decreases the signals that cause muscles to tighten involuntarily, resulting in reduced muscle tone and fewer spasms.

Understanding how Tizanidine works helps explain why certain alternatives may or may not be a good fit for you — different medications target spasticity through different mechanisms. For a deeper dive, read our article on how Tizanidine works.

Alternatives to Tizanidine

The right alternative depends on your specific condition, other medications you take, and your medical history. Here are the most commonly prescribed options:

1. Baclofen (Lioresal)

Baclofen is one of the closest alternatives to Tizanidine for treating spasticity. It works as a GABA-B receptor agonist, reducing nerve signals in the spinal cord that cause muscle tightness.

• Best for: Spasticity from MS, spinal cord injuries, and cerebral palsy
• Available as: Tablets (5 mg, 10 mg, 20 mg) and intrathecal pump
• Common side effects: Drowsiness, dizziness, weakness, nausea
• Key difference: Clinical studies show similar effectiveness to Tizanidine, but Baclofen may cause more muscle weakness. Baclofen also has an intrathecal (spinal pump) option for severe spasticity.
• Cost: Generic Baclofen is inexpensive, typically $10 to $20 for a 30-day supply with a discount card.

2. Cyclobenzaprine (Flexeril)

Cyclobenzaprine is one of the most widely prescribed muscle relaxants in the U.S. It works differently from Tizanidine — acting in the brainstem to reduce motor neuron activity rather than at the spinal cord level.

• Best for: Acute musculoskeletal pain and muscle spasms (not typically used for spasticity from neurological conditions)
• Available as: Tablets (5 mg, 7.5 mg, 10 mg) and extended-release capsules (15 mg, 30 mg)
• Common side effects: Drowsiness, dry mouth, dizziness, fatigue
• Key difference: Cyclobenzaprine is better suited for short-term muscle spasm relief (2-3 weeks) rather than ongoing spasticity management. It's structurally related to tricyclic antidepressants and should not be used with MAO inhibitors.
• Cost: Generic Cyclobenzaprine costs about $8 to $15 for a 30-day supply with discount cards.

3. Methocarbamol (Robaxin)

Methocarbamol is a centrally acting muscle relaxant that's available both by prescription and over the counter in some countries. Its exact mechanism isn't fully understood, but it's thought to work through general CNS depression.

• Best for: Acute musculoskeletal pain and muscle spasms
• Available as: Tablets (500 mg, 750 mg) and injectable solution
• Common side effects: Drowsiness, dizziness, lightheadedness, nausea
• Key difference: Methocarbamol tends to cause less sedation than Tizanidine and Cyclobenzaprine, making it a better option for people who need to stay alert. However, it's generally considered less effective for neurological spasticity.
• Cost: Generic Methocarbamol costs about $10 to $25 for a 30-day supply.

4. Dantrolene (Dantrium)

Dantrolene is unique among muscle relaxants because it works directly on skeletal muscle rather than in the central nervous system. It reduces muscle contraction by interfering with calcium release inside muscle cells.

• Best for: Severe spasticity from MS, spinal cord injury, stroke, or cerebral palsy — especially when other medications haven't worked
• Available as: Capsules (25 mg, 50 mg, 100 mg) and injectable solution
• Common side effects: Drowsiness, dizziness, weakness, diarrhea, fatigue
• Key difference: Dantrolene carries a risk of serious liver damage (hepatotoxicity) and requires regular liver function monitoring. It's generally reserved for patients who haven't responded to other treatments.
• Cost: More expensive than other options — generic Dantrolene may cost $30 to $80+ per month depending on the dose.

Important: Don't Switch on Your Own

Never stop Tizanidine or switch to another medication without talking to your doctor. Tizanidine needs to be tapered gradually if you've been taking it regularly — stopping abruptly can cause rebound hypertension (dangerous spikes in blood pressure) and worsening spasticity.

Your prescriber will consider your specific condition, other medications (especially potential drug interactions), and medical history when recommending the best alternative for you.

Final Thoughts

If you can't fill your Tizanidine prescription, you have options. Baclofen is the closest substitute for spasticity, while Cyclobenzaprine and Methocarbamol may work for musculoskeletal pain. Dantrolene is available for more severe cases. Each comes with its own set of benefits and trade-offs.

In the meantime, if the issue is just finding Tizanidine in stock, try using Medfinder to locate a pharmacy near you that has it available. You can also read our guide on how to find Tizanidine in stock for more tips.