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Clonidine has some role in the treatment of spasticity, acting principally by inhibiting excessive sensory transmission below the level of injury [clarify]. Its use, however, is mainly as a second or third line agent, due to side effects such as hypotension, bradycardia, and drowsiness. [42]
At a dose of 2 mg per day of rilmenidine, controlled comparative studies versus clonidine (0.15 to 0.30 mg/day) or alpha-methyldopa (500 to 1000 mg/day) demonstrated that the incidence of side effects was significantly lower with rilmenidine than with either clonidine or a-methyldopa. Side-effects are rare, non-severe, and transient at ...
Clonidine and other imidazoline compounds have also been shown to reduce muscle spasms by their central nervous system activity. Tizanidine is perhaps the most thoroughly studied clonidine analog, and is an agonist at α 2-adrenergic receptors, but reduces spasticity at doses that result in significantly less hypotension than clonidine. [26]
Medications such as clonidine and dexmedetomidine target pre-synaptic auto receptors, therefore leading to an overall decrease in norepinephrine which clinically can cause effects such as sedation, analgesia, lowering of blood pressure and bradycardia. There is also low quality evidence that they can reduce shivering post operatively.
The side effects could be severe dizziness, fast heartbeat, and swelling of face, lips, tongue, eyelids, hands and feet. Lesser side effects include stomach pain, diarrhea and hypotension. Peripheral edema , a common side effect from the use of amlodipine , was reduced when patients were shifted to cilnidipine.
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Common side effects of tizanidine include dry mouth, sleepiness, weakness, and dizziness. [5] Serious side effects may include low blood pressure, liver problems, psychosis, and QT prolongation. [5] It is unclear if use in pregnancy and breastfeeding is safe. [6] It is an α 2-adrenergic agonist, but how it works is not entirely clear. [5]
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