Movax Tablets 4mg (Tizanidine)
SAMI Pharmaceuticals Pvt. Ltd.DRAP reg. 042139
Prescription required
It must never be taken with ciprofloxacin, and it needs liver tests, so a doctor should prescribe it. We accept a prescription from any registered doctor in Pakistan.
Same day or next day in Karachi, Lahore, Islamabad, Rawalpindi for orders confirmed before 6pm. Tracked courier, 2 to 4 working days everywhere else. Delivery Rs 250 in Rawalpindi and Islamabad, Rs 300 everywhere else, cash on delivery. Delivery details
Prices in PKR, checked 15 October 2026.
What Movax is
A muscle relaxant tablet containing tizanidine 4 mg, made by SAMI Pharmaceuticals in Karachi.
- Registered with DRAP under number 042139. DRAP’s registry gives a registration date of 21 January 2006 and SAMI Pharmaceuticals Pvt. Ltd., Karachi, as the holder. Movax 2mg is registered separately; we list the 4 mg tablet only.
- DRAP’s registry for Movax 4 mg (042139), read 16 October 2026, lists two pack sizes, 10's and 2x10's, so a 20-tablet carton printed as 2 × 10 matches a listed pack. SAMI’s product information gives a pack of 20.
- The record disagrees with itself: its “Variation Status” field reads “No Variations”, yet under “Applied Variations (Pending)” it lists two applications titled “Approval of Grant of additional pack size (non essential drugs)”. One, applied on 24 December 2025, would change “10's” to “10's & 2x10's”, although 2x10's already appears in the pack table. The other, applied on 9 February 2026, would change “10's, 2x10's” to “10's, 2x10's & 1x20's”.
- A Pakistani pharmacy’s product photograph of the Movax 4 mg 20-tablet carton, viewed 17 October 2026, prints “2 x 10 Tablets”: that is the listed 2x10's pack, and the pending 1x20's application is for a different pack. That is another pharmacy’s photograph, not our own pack; we sell the same 20-tablet Movax 4 mg pack and have not yet read our own carton.
- DRAP’s notified price index has no entry for Movax, and the registry lists both packs as de-controlled with no approved price. We list the price pharmacies charge until we have read the price printed on our own carton.
- Prescription: SAMI’s product information for Movax gives the condition of sale in its Urdu instructions: “صرف رجسٹرڈ ڈاکٹر کے نسخے کے مطابق فروخت کریں” (sell only on a registered doctor’s prescription). So we ask for a photo of your prescription with your order, checked by our pharmacist.
What is in each tablet
One active ingredient, from the label claim in DRAP’s registry.
| Active ingredient | Per tablet |
|---|---|
| Tizanidine (as tizanidine hydrochloride) | 4 mg |
DRAP’s label claim reads: “Each tablets contains: Tizanidine Hydrochloride eq. to Tizanidine…..…...4mg”: 4 mg of tizanidine itself, which SAMI’s product information also states (“Tizanidine Hydrochloride USP equivalent to Tizanidine.…….4mg”). The registry’s composition grid lists “Tizanidine Hydrochloride = 4 mg”, without the equivalence. We read the grid as shorthand for the same formulation, because two separate documents, DRAP’s own label claim and SAMI’s product information, both state the equivalence. Only a literal reading of the grid would imply less tizanidine: 4 mg of the hydrochloride salt is about 3.5 mg of tizanidine, roughly 12% less. SAMI describes the 4 mg tablet as light pink and capsule-shaped, with SAMI engraved on one side and a break line on the other.
What it is approved for
SAMI’s own product information approves Movax for spasticity only: muscle stiffness from multiple sclerosis or spinal cord injury or disease. Some countries also approve tizanidine for painful muscle spasm and low back pain; others do not.
| Source | Approved for |
|---|---|
| SAMI, Movax (Pakistan) | “Treatment of spasticity associated with multiple sclerosis or with spinal cord injury or disease.” Spasticity only. |
| Ireland, Zanaflex (June 2022) | The same wording as SAMI’s: spasticity only. |
| US, Zanaflex | “the treatment of spasticity in adults.” |
| Canada, APO-Tizanidine | “the management of spasticity.” |
| UK, Tizagelan (a generic, October 2021) | Spasticity, and “Spasms of the skeletal muscles” with disorders of the spine (“cervical and lumbar syndromes”) and after surgery such as for a herniated disc. |
| Austria, Sirdalud (March 2023) | Spasticity, and painful muscle spasm with disorders of the spine, such as a stiff neck (torticollis) or lumbago. |
| Japan, Ternelin | Spastic paralysis, and muscle tension in neck–shoulder–arm syndrome and low back pain (頸肩腕症候群、腰痛症). |
Low back pain is an approved use in the UK, Austria and Japan, but not in SAMI’s own product information for Movax. Prescribing it for back pain is your doctor’s call.
It is a muscle relaxant: none of these labels lists it for pain on its own, though SAMI’s label says it also has a moderate pain-relieving effect on painful spasms.
Never with ciprofloxacin: what each regulator says
Ciprofloxacin blocks the liver enzyme (CYP1A2) that clears tizanidine from the body, so tizanidine builds up. Every label we checked forbids taking them together.
| Source | What it says |
|---|---|
| SAMI, Movax (Pakistan), 4.3 and 4.5 | “Concomitant use of tizanidine with strong inhibitors of CYP1A2 such as fluvoxamine or ciprofloxacin is contraindicated.” Together they “resulted in a 33-fold and 10-fold increase in tizanidine AUC, respectively. Clinically significant and prolonged hypotension may result along with somnolence, dizziness and decreased psychomotor performance.” |
| SAMI, Novidat (ciprofloxacin), 4.3 and 4.5 | Contraindicated: “Concomitant administration of ciprofloxacin and tizanidine.” “Tizanidine must not be administered together with ciprofloxacin.” |
| US, Zanaflex, 4, 7.1 and 12.3 | Contraindicated with strong CYP1A2 inhibitors (“e.g., fluvoxamine, ciprofloxacin”), which “resulted in significantly decreased blood pressure, increased drowsiness”. With ciprofloxacin, peak level and total exposure rose 7-fold and 10-fold. |
| US, Cipro (ciprofloxacin), 4.2 | “Concomitant administration with tizanidine is contraindicated.” |
| Canada, APO-Tizanidine | Contraindicated with “moderate and potent CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin”. |
| UK (Tizagelan), Ireland (Zanaflex), Austria (Sirdalud), Japan (Ternelin) | All four contraindicate it: UK, Ireland, Austria, Japan. |
SAMI’s Movax product information also says other medicines that slow the same enzyme are “not recommended” with tizanidine: some heart-rhythm medicines (amiodarone, mexiletine, propafenone), cimetidine, other quinolone antibiotics (enoxacin, pefloxacin, norfloxacin), rofecoxib, oral contraceptives and ticlopidine. Fluvoxamine (“used to treat mental health problems”, Canada’s label says) is contraindicated like ciprofloxacin.
Liver tests
Tizanidine can affect the liver. Every label we cite except Japan’s asks for liver blood tests, and they disagree on how often; Japan’s says liver function worsening has been reported.
| Source | What it says |
|---|---|
| SAMI, Movax (Pakistan) | Before starting, then “monitored monthly for the first four months of treatment in all patients”, and in anyone with unexplained nausea, loss of appetite or tiredness. Stop it if liver enzymes stay above three times normal, or with signs of hepatitis or jaundice. |
| Ireland, Zanaflex | The same as SAMI’s: monthly for the first four months, in all patients. |
| UK, Tizagelan | Monthly for the first four months for people on higher doses, and anyone with symptoms of liver problems. |
| US, Zanaflex | “at baseline and 1 month after maximum dose is achieved”, or if liver injury is suspected. |
| Canada, APO-Tizanidine | “during the first 6 months of treatment (e.g., baseline, 1, 3 and 6 months) and periodically thereafter”. |
SAMI’s product information says Movax must not be used by anyone whose liver function is significantly impaired.
Who must not take it, and who needs care
SAMI’s Movax product information says it must not be taken by people with:
- Warning: Significantly impaired liver function.
- Warning: Ciprofloxacin or fluvoxamine, or any strong CYP1A2 inhibitor.
- Warning: An allergy to tizanidine or any ingredient.
Caution, from the same source: low blood pressure, which can be severe (fainting, collapse), especially with blood pressure medicines; heart disease; kidney or liver problems; myasthenia gravis; and epilepsy, which should be well controlled. It is not recommended under 18, or for older people unless the benefit clearly outweighs the risk. The tablets contain lactose.
Don’t stop it suddenly
SAMI’s Movax product information: “Tizanidine should not be stopped abruptly, but rather gradually.”
Stopping suddenly after long use, high doses or use with blood pressure medicines has caused a rebound rise in blood pressure and a fast heartbeat; in extreme cases the rebound “might lead to cerebrovascular accident” (a stroke). The US Zanaflex label also lists rebound muscle stiffness. Ask your doctor how to stop.
Other medicines and alcohol
From SAMI’s Movax product information, section 4.5, unless another source is named. Tell the prescriber everything you take.
| With | What happens |
|---|---|
| Ciprofloxacin, fluvoxamine | Contraindicated: tizanidine levels rise 10- to 33-fold. |
| Blood pressure medicines, including water tablets (diuretics); beta-blockers; digoxin | Blood pressure may fall further, or the heart slow. Stopping tizanidine suddenly while on them can cause a rebound. |
| Alcohol, and medicines that cause drowsiness (sedatives, sleeping tablets, antipsychotics, some painkillers, antihistamines) | More drowsiness. The US Zanaflex label adds: “Alcohol increases the exposure of tizanidine”. |
| Oral contraceptives (the pill) | Tizanidine is cleared about 50% more slowly, so side effects may come at lower doses. |
| Other muscle relaxants | Increased effects. |
| Rifampicin | Tizanidine levels fall by half; it may work less well. |
| Smoking (more than 10 cigarettes a day, men) | About 30% less tizanidine in the body. |
| Medicines that lengthen the QT interval | Caution; heart tracing (ECG) monitoring may be advisable. |
Pregnancy, breastfeeding and contraception
The labels word it differently. The UK label says it should not be used in pregnancy unless the benefit clearly outweighs the risk; SAMI’s says the data are limited and animal studies showed harm, and asks women who could become pregnant to use contraception; the US label says there are no adequate data.
| Source | What it says |
|---|---|
| SAMI, Movax (Pakistan) | Limited data in pregnancy; animal studies showed reproductive toxicity. Women who could become pregnant should take a pregnancy test before starting, and “have to use effective contraception during and up to one day after treatment”. It “should not be taken by women who are breast-feeding”. |
| UK, Tizagelan | “tizanidine should not be used in pregnant women unless the benefit clearly outweighs the risk.” The same for nursing mothers. |
| US, Zanaflex | “There are no adequate data on the developmental risk associated with use of Zanaflex in pregnant women.” No data on tizanidine in human milk. |
Side effects
From SAMI’s Movax product information, section 4.8.
| How often | Side effects |
|---|---|
| Very common (more than 1 in 10) | Drowsiness, dizziness, dry mouth, stomach upset, muscle weakness, tiredness. |
| Common (up to 1 in 10) | Low blood pressure, slow or fast heartbeat, trouble sleeping, nausea, raised liver enzymes, rebound high blood pressure on stopping. |
| Rare (up to 1 in 1,000) | Hallucinations; itching, rash. |
| Very rare | Hepatitis, liver failure. |
| Not known | Allergic reactions including anaphylaxis; confusion, anxiety; headache, unsteadiness, slurred speech; blurred vision; fainting; QT prolongation; loss of appetite; stomach pain, vomiting. |
Driving: “patients experiencing drowsiness or dizziness should be advised against activities requiring a high degree of alertness” (SAMI).
Checking your pack is genuine
As of 15 October 2026, no DRAP alert names Movax. Two alerts this year concern a different tizanidine brand.
- SAMI describes genuine Movax 4 mg as light pink, capsule-shaped tablets with SAMI engraved on one side and a break line on the other.
- Check that the batch number and expiry are printed on the carton and the blister.
DRAP Alerts No. II/S/04-26-23 and I/S/05-26-26, 14 April and 4 May 2026: Not Movax: Kadin 2 mg tablets (tizanidine), from FYNK Pharmaceuticals, Lahore, batches 569 (April alert) and 570 (May alert), declared “adulterated” by Drug Testing Laboratories: “Paracetamol identified”. A tablet sold as tizanidine was found to contain paracetamol.
We buy only from authorised distributors, and check the batch and expiry on every item before it is packed.
Information as of 15 October 2026. DRAP publishes new alerts on dra.gov.pk.
Returns and replacements
Medicines and supplements can’t be returned once they have left our pharmacy.
- Returned medicine can never go back into saleable stock. That is a safety rule, not a commercial one.
- If an item arrives damaged or wrong, tell us on WhatsApp within 24 hours and we replace it. That is us fixing our mistake, not a return.
- Anything that arrives expired or within a month of expiry we replace or refund, your choice, with no time limit.
Frequently asked questions
What is Movax medicine used for?
SAMI’s product information approves Movax (tizanidine) for spasticity: muscle stiffness caused by multiple sclerosis or spinal cord injury or disease. Painful muscle spasm and low back pain are approved uses in the UK, Austria and Japan, but not in SAMI’s own label. It must never be taken with the antibiotic ciprofloxacin.
Is Movax a sleeping pill?
No. It is a muscle relaxant, approved for spasticity. But drowsiness is one of its most common side effects, in more than 1 in 10 people (SAMI’s product information), and alcohol, sedatives and sleeping tablets add to it. SAMI advises against activities that need you to be alert if it makes you drowsy or dizzy.
Is Movax safe for kidneys?
It needs care. SAMI’s product information says people with kidney problems may need lower doses, start more slowly and should have their kidney function monitored, and that kidney clearance may be up to three times lower in older people. If you have kidney disease, tell your doctor before taking it.
What is tizanidine used for?
Spasticity, in every country we checked: muscle stiffness from conditions such as multiple sclerosis or spinal cord injury. The UK, Austria and Japan also approve it for painful muscle spasm with spine problems and low back pain; the US, Canada, Ireland and SAMI’s Pakistani label do not.
What are the worst side effects of tizanidine?
From SAMI’s product information: severe low blood pressure (fainting, collapse), especially with ciprofloxacin, fluvoxamine or blood pressure medicines; liver damage, rarely hepatitis or liver failure, which is why liver tests are needed; hallucinations (rare); and a rebound rise in blood pressure and fast heartbeat if it is stopped suddenly, which in extreme cases might lead to a stroke.
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Questions about Movax Tablets 4mg (Tizanidine)?
Send your question on WhatsApp and a pharmacist will come back to you.
Written by the ePharmacyy pharmacy team.
Last checked against the sources below on
DRAP registration
- Movax 4mg Tablets (042139), SAMI Pharmaceuticals Pvt. Ltd. DRAP’s registry shows: Provisionally Active, “Not Verified”.
- Movax 2mg Tablet (025594), SAMI Pharmaceuticals Pvt. Ltd. DRAP’s registry shows: Provisionally Active, “Not Verified”.
DRAP publishes no definition of this verification flag, so we can’t tell you what it means. We searched DRAP’s website for “Movax” and “tizanidine” on 16 October 2026 and found no alert naming Movax; two recall alerts about another maker’s tizanidine (under “Checking your pack is genuine”). When we tested it, the search did not find a word that appears only inside an alert’s attached PDF, so an alert that names a product only in its PDF may not show up. DRAP describes its registered products index as a provisional list that “cannot be used as a reference for any purpose”. Checked against the registry on .
Sources
- DRAP registered products: Movax 4mg Tablets, registration 042139
- DRAP registered products: Movax 2mg Tablet, registration 025594
- SAMI Pharmaceuticals: Movax (tizanidine) product information (SmPC, R.N-06/QC/01/2025, PDF)
- SAMI Pharmaceuticals: Novidat (ciprofloxacin) product information (SmPC, PDF)
- US label: Zanaflex (tizanidine) tablets and capsules (DailyMed)
- US label: Cipro (ciprofloxacin) (Bayer, DailyMed)
- UK SmPC: Tizagelan 2 mg tablets (G.L. Pharma, revised 25 October 2021)
- Health Canada: APO-Tizanidine product monograph (PDF)
- Ireland SmPC: Zanaflex 2 mg tablets (HPRA, June 2022, PDF)
- Austria Fachinformation: Sirdalud 4 mg (BASG, March 2023, PDF)
- Japan package insert: Ternelin (tizanidine) (PMDA, Japanese, PDF)
- DRAP Alert No. II/S/04-26-23 (14 April 2026, PDF)
- DRAP Alert No. I/S/05-26-26 (4 May 2026, PDF)