Tizanidine Use in Hemodialysis Patients with ESRD

Alternative Options for Back Spasms in ESRD

• Baclofen can be used for back spasms in patients with renal impairment, with the Society for Perioperative Assessment and Quality Improvement (SPAQI) recommending continuing baclofen in patients with renal impairment, including on the day of procedures, by adjusting the dosage through increasing the dosing interval rather than decreasing the dose 1
• For patients with muscle spasms and ESRD, medication selection should prioritize drugs that are not primarily renally cleared, as recommended by the American Thoracic Society 2

Management Algorithm for Muscle Relaxants in ESRD

• When medication is needed, choose muscle relaxants that are not primarily renally cleared, and consider baclofen with appropriate dosage adjustment, as suggested by the Mayo Clinic Proceedings 1, 2