Potential for hepatotoxicity. AST/ALT elevations and rarely hepatic failure occurred. Dose-related sedation common. Significant and severe sedation may also occur (use with caution in risk for sedative effects). Hypotensive effects may be potentiated when used with antihypertensives. Sedative effects may be potentiated when used with other CNS depressants. Avoid or use extreme caution in hepatic impairment (potential for effects probably due to extensive hepatic metabolism of tizanidine). In general, avoid use in patients taking other CYP1A2 inhibitors. Dose-related significant hypotension may occur (use with caution in patients with cardiac disease or those at risk for severe hypotensive effects). Withdrawal resulting in rebound hypertension, tachycardia, and hypertonia may occur upon discontinuation. Use with caution in renal impairment (clearance decreased significantly in severe impairment (CrCl <25 mL/minute)). Use associated with visual hallucinations or delusions, generally in first 6 weeks of therapy. Use caution in psychiatric disorders. Food alters absorption profile relative to administration under fasting conditions. In addition, bioequivalence between capsules and tablets altered by food. Capsules and tablets bioequivalent under fasting conditions, but not under nonfasting conditions.