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The influence on blood pressure of the combined use of tizanidine hydrochloride and fluvoxamine maleate was investigated in the Mie Chuo Medical Center. The average decreases in systolic pressure and diastolic pressure were 17.8 mmHg and 9.5 mmHg, respectively, these decreases in blood pressure being significant. The influence on blood pressure of other combinations was also investigated. These were tizanidine hydrochloride and paroxetine hydrochloride hydrate, another selective serotonin reuptake inhibitor (SSRI) which inhibits CYP1A2, and tizanidine hydrochloride with eperisone hydrochloride, which is metabolized by a CYP1A enzyme in the same family, and fluvoxamine maleate. Significant decreases in blood-pressure were not observed with these combinations so we consider that they may be used with comparative safety.

Decrease in Blood-Pressure due to Combined Use of Muscle Relaxants and Selective Serotonin Reuptake Inhibitors (SSRIs)