Zanaflex vs. Ultram

Are Zanaflex and Ultram the Same Thing?

Zanaflex (tizanidine hydrochloride) and Ultram (tramadol) are used to treat painful muscle conditions.

Zanaflex is used to treat muscle tightness and cramping (spasm) caused by conditions such as multiple sclerosis or spinal injury.

Ultram is used to treat moderate to moderately severe pain in adults.

Zanaflex and Ultram belong to different drug classes. Zanaflex is a muscle relaxant and Ultram is a pain reliever (analgesic).

Side effects of Zanaflex and Ultram that are similar include anxiety, nervousness, stomach pain or upset, diarrhea, constipation, vomiting, fever, drowsiness, dizziness, and skin rash.

Side effects of Zanaflex that are different from Ultram include numbness or tingling, dry mouth, muscle weakness, back pain, increased muscle tone or spasms, sweating, and fatigue.

Side effects of Ultram that are different from Zanaflex include agitation, seizures (convulsions), spinning sensation, hallucinations, fast heart rate, overactive reflexes, nausea, loss of coordination, headache, and fainting.

Both Zanaflex and Ultram may interact with alcohol and certain antiviral medications.

Zanaflex may also interact with cimetidine, famotidine, ticlopidine, zileuton, birth control pills, antibiotics, blood pressure medications, or heart rhythm medications.

Ultram may also interact with monoamine oxidase inhibitors (MAOIs), antidepressants, antibiotics, antifungals, heart or blood pressure medications, seizure medications, cold or allergy medicines, bronchodilator asthma/COPD medications, diuretics (water pills); medicines for motion sickness, irritable bowel syndrome, or overactive bladder; other narcotics, drugs that make you sleepy or slow your breathing (sedatives, sleeping pills, muscle relaxers, medicines to treat mood disorders or mental illness), stimulants, or medicine for Parkinson's disease, migraine headache medicines, medications to treat serious infections, and medicines to treat nausea and vomiting.

Do not stop using Zanaflex or Ultram suddenly, or you could have unpleasant withdrawal symptoms.

What Are Possible Side Effects of Zanaflex?

Common side effects of Zanaflex include:

  • anxiousness,
  • nervousness,
  • numbness or tingling,
  • stomach pain,
  • diarrhea,
  • constipation,
  • vomiting,
  • fever,
  • dry mouth,
  • drowsiness,
  • dizziness,
  • muscle weakness,
  • back pain,
  • increased muscle tone or spasms,
  • sweating,
  • skin rash, and
  • fatigue.

What Are Possible Side Effects of Ultram?

Common side effects of Ultram include:

  • agitation,
  • nervousness,
  • anxiety,
  • seizures (convulsions),
  • skin rash,
  • dizziness,
  • spinning sensation,
  • hallucinations,
  • fever,
  • fast heart rate,
  • overactive reflexes,
  • nausea,
  • vomiting,
  • upset stomach,
  • diarrhea,
  • constipation,
  • loss of coordination,
  • headache,
  • drowsiness, and
  • fainting.

What Is Zanaflex?

Zanaflex is used to treat conditions such as multiple sclerosis or spinal injury.

What Is Ultram?

Ultram is a strong prescription pain medicine that contains an opioid (narcotic) that is used for the management pain in adults, when other pain treatments such as non-opioid pain medicines do not treat your pain well enough or you cannot tolerate them. Ultram is an opioid pain medicine that can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.

What Drugs Interact With Zanaflex?

Zanaflex may interact with alcohol. Zanaflex may also interact with different drugs including acyclovir, cimetidine, amotidine, ticlopidine, zileuton, birth control pills, antibiotics, blood pressure medications, or heart rhythm medications.

What Drugs Interact With Ultram?

Ultram is contraindicated in patients receiving MAO inhibitors or who have used them within the previous 14 days.

How Should Zanaflex Be Taken?

Zanaflex should be taken exactly as prescribed (consistently either with or without food) and not to switch between tablets and capsules. Inform patients that they should not take more Zanaflex than prescribed because of the risk of adverse events at single doses greater than 8 mg or total daily doses greater than 36 mg. Tell patients that they should not suddenly discontinue Zanaflex, because rebound hypertension and tachycardia may occur.

How Should Ultram Be Taken?

Do not change your dose. Take Ultram exactly as prescribed by your healthcare provider. Use the lowest dose possible for the shortest time needed.

Take your prescribed dose as indicated by your health care provider. The maximum dosage is 1 or 2 tablets every 4 to 6 hours, as needed for pain relief. Do not take more than your prescribed dose and do not take more than 8 tablets per day. If you miss a dose, take your next dose at your usual time.

Call your healthcare provider if the dose you are taking does not control your pain.

If you have been taking Ultram regularly, do not stop taking Ultram without talking to your healthcare provider.

After you stop taking Ultram, ask your pharmacist how to dispose of any unused tablets.


All drug information provided on is sourced directly from drug monographs published by the U.S. Food and Drug Administration (FDA).

Any drug information published on regarding general drug information, drug side effects, drug usage, dosage, and more are sourced from the original drug documentation found in its FDA drug monograph.

Drug information found in the drug comparisons published on is primarily sourced from the FDA drug information. The drug comparison information found in this article does not contain any data from clinical trials with human participants or animals performed by any of the drug manufacturers comparing the drugs.

The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. assumes no responsibility for any healthcare administered to a person based on the information found on this site.

As drug information can and will change at any time, makes every effort to update its drug information. Due to the time-sensitive nature of drug information, makes no guarantees that the information provided is the most current.

Any missing drug warnings or information does not in any way guarantee the safety, effectiveness, or the lack of adverse effects of any drug. The drug information provided is intended for reference only and should not be used as a substitute for medical advice.

If you have specific questions regarding a drug’s safety, side effects, usage, warnings, etc., you should contact your doctor or pharmacist, or refer to the individual drug monograph details found on the or websites for more information.

You may also report negative side effects of prescription drugs to the FDA by visiting the FDA MedWatch website or calling 1-800-FDA-1088.


FDA. Zanaflex Drug Information.

FDA. Ultram Product Information.

Health Solutions From Our Sponsors