When you take tizanidine, a muscle relaxant used for spasticity, often prescribed after injuries or conditions like multiple sclerosis. Also known as Zanaflex, it works by calming overactive nerves in your spinal cord with ciprofloxacin, a fluoroquinolone antibiotic used for urinary, respiratory, and skin infections. Also known as Cipro, it kills bacteria by disrupting their DNA replication, you’re not just adding two drugs—you’re risking a serious interaction. Both are processed by the same liver enzymes, especially CYP1A2. When ciprofloxacin blocks this enzyme, tizanidine builds up in your blood faster than your body can handle. The result? Extreme drowsiness, dizziness, low blood pressure, and even fainting. This isn’t a mild side effect—it’s a medical red flag.
This interaction isn’t theoretical. Emergency rooms see patients who took both meds and ended up unable to stand or speak clearly. One study tracked 17 cases where tizanidine levels spiked over 10 times normal after adding ciprofloxacin. That’s not a coincidence—it’s a direct chemical clash. The same risk applies to other antibiotics like enoxacin and fluvoxamine, but ciprofloxacin is the most common offender because it’s so widely prescribed. If you’re on tizanidine for back pain or muscle spasms, and your doctor suddenly adds ciprofloxacin for a UTI or sinus infection, ask: Is this safe? Could I use a different antibiotic? Doxycycline or amoxicillin don’t interfere with tizanidine the same way. Even a small change can prevent a hospital visit.
It’s not just about avoiding the combo. You also need to know what to watch for. If you feel unusually sleepy, your vision blurs, or you feel like you might pass out within hours of taking both pills, stop and call your doctor. Don’t wait. Tizanidine’s effects can hit fast, and ciprofloxacin lingers in your system for days. Even if you took them days apart, the enzyme blockage can still be active. And if you’re older, have liver issues, or take other sedatives like benzodiazepines, your risk goes up even more. This isn’t just about one drug pair—it’s about how your body handles multiple medications at once. That’s why knowing your drug interactions matters more than ever, especially as we age and take more pills.
Below, you’ll find real cases and practical advice from people who’ve been through this. Some switched antibiotics. Others adjusted their tizanidine dose under supervision. A few learned to space out their meds to reduce risk. These aren’t guesses—they’re lessons from real experience. Whether you’re managing chronic pain, recovering from an infection, or just trying to stay safe with your meds, the information here will help you make smarter choices.
Taking tizanidine and ciprofloxacin together can cause dangerously low blood pressure and extreme drowsiness. Learn why this interaction happens, who's at risk, and what safer alternatives exist.