Tr. Johnson et Jd. Tobias, Hypotension following the initiation of tizanidine in a patient treated with an angiotensin converting enzyme inhibitor for chronic hypertension, J CHILD NEU, 15(12), 2000, pp. 818-819
Centrally acting alpha-2 adrenergic agonists are one of several pharmacolog
ic agents used in the treatment of spasticity related to disorders of the c
entral nervous system. In addition to their effects on spasticity, certain
adverse cardiorespiratory effects have been reported. Adults chronically tr
eated with angiotensin converting enzyme inhibitors may have a limited abil
ity to respond to hypotension when the sympathetic response is simultaneous
ly blocked. The authors present a 10-year-old boy chronically treated with
lisinopril, an angiotensin converting enzyme inhibitor, to control hyperten
sion who developed hypotension following the addition of tizanidine, an alp
ha-2 agonist, for the treatment of spasticity The possible interaction of t
izanidine and other antihypertensive agents should be kept in mind when pre
scribing therapy to treat either hypertension or spasticity in such patient
s.