Drug General Information (ID: DDIYMEIR58)
Drug Name			Entacapone		Drug Info		Tizanidine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiparkinson Agents				Analgesics
Structure

Mechanism of Entacapone-Tizanidine Interaction (Severity Level: Moderate)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Entacapone				Tizanidine
Mechanism		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Entacapone and Tizanidine

Recommended Action
Management		Caution is advised and more gradual dose titration may be appropriate when tizanidine is used with other substances that can cause CNS depression and/or hypotension, particularly in elderly or debilitated patients. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to avoid rising abruptly from a sitting or recumbent position. Patients should contact their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or excessive CNS effects that interfere with their normal activities.

References
1	Product Information. Zanaflex (tizanidine). Acorda Therapeutics, Hawthorne, NY.