International, Inc. May, 2016. What happens if I overdose Zanaflex? Sedation: Sedation may occur; use with caution in patients at risk for sedative effects eg, patients taking concurrent CNS depressants; patients must be cautioned about performing tasks which require mental alertness eg, operating machinery or driving. buy ciprofloxacin 400 mg uk ciprofloxacin
Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Contact your doctor if these problems occur. Monitor for hypotension in at-risk patients and those receiving concomitant antihypertensive therapy. buy zovirax uk forum
Your pharmacist can provide more information about tizanidine. Use tizanidine as directed by your doctor. Check the label on the medicine for exact dosing instructions. DD sleep on the back? RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions.
This disease entry is based upon medical information available through the date at the end of the topic. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Lundbeck August 13, 2012. Brimonidine Topical: May enhance the CNS depressant effect of CNS Depressants. vidalta
The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist. Store tizanidine at 77 degrees F 25 degrees C. Brief storage at temperatures between 59 and 86 degrees F 15 and 30 degrees C is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep tizanidine out of the reach of children and away from pets. Food has complex effects on tizanidine pharmacokinetics, which differ with the different formulations. Zanaflex Capsules and Zanaflex tablets are bioequivalent to each other under fasting conditions more than 3 hours after a meal but not under fed conditions within 30 minutes of a meal. These pharmacokinetic differences may result in clinically significant differences when switching administration of tablet and capsules and when switching administration between the fed or fasted state. These changes may result in increased adverse events, or delayed or more rapid onset of activity, depending upon the nature of the switch. Warning: The facts and figures contained in these reports are accurate to the best of our capability; however, our metrics are only meant to augment your medical knowledge, and should never be used as the sole basis for selecting a new medication. As with any medical decision, be sure to work with your doctor to ensure the best choices are made for your condition. The intramuscular dosage will vary with the condition being treated. Allergic reactions: Allergic or hypersensitivity reactions, anaphylactoid reaction, anaphylaxis, angioedema. If you start on the first day of your period, you do not need to use back-up birth control the first week. If you are taking the chewable pill, chew and swallow one pill every day. Some brands may also be swallowed whole. Some brands should be taken with water while others should be taken without water. Carefully follow the manufacturer's directions for your brand. Zanaflex is administered to a nursing woman. Extensively metabolized in the liver and significant effects are expected; use not recommended in patients with hepatic impairment. If this complication occurs and the diagnosis of sepsis is confirmed, appropriate antimicrobial therapy should be instituted. Abuse potential was not evaluated in human studies. The CNS depressant effects of tizanidine and alcohol are additive. Check your pressure regularly and tell your doctor if the results are high. Similarly, corticosteroids should be used with great care in patients with known or suspected Strongyloides threadworm infestation. In such patients, corticosteroid-induced immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia. Shingles is a painful condition that arises from varicella-zoster, the same virus that causes chickenpox. Learn more about the symptoms and risk factors.
Paraldehyde: CNS Depressants may enhance the CNS depressant effect of Paraldehyde. Analgesics Opioid: CNS Depressants may enhance the CNS depressant effect of Analgesics Opioid. Management: Avoid concomitant use of opioid analgesics and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. NegGram nalidixic acid US prescribing information. Trimeprazine: May enhance the CNS depressant effect of CNS Depressants. Educate patient about signs of a significant reaction eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. Alcohol increased the AUC of tizanidine by approximately 20%, while also increasing its C max by approximately 15%. This was associated with an increase in side effects of tizanidine. The CNS depressant effects of tizanidine and alcohol are additive. Zanaflex treated group compared to placebo. Glucocorticoids, naturally occurring and synthetic, are adrenocortical steroids. Hepatic effects: Potential for hepatotoxicity; monitor aminotransferases prior to and during use or if hepatic injury is suspected. Spasticity: Oral: Initial: 2 mg up to 3 times daily at 6- to 8-hour intervals as needed; may titrate to optimal effect in 2-4 mg increments per dose with a minimum of 1-4 days between dose increases; maximum: 36 mg daily. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Abuse potential was not evaluated in human studies. Rats were able to distinguish tizanidine from saline in a standard discrimination paradigm, after training, but failed to generalize the effects of morphine, cocaine, diazepam, or phenobarbital to tizanidine. amoxicillin
Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in clinical practice. Learn the subtle differences of muscle injuries and pain. Persons who are on corticosteroids are more susceptible to infections than are healthy individuals. There may be decreased resistance and inability to localize infection when corticosteroids are used. Infections with any pathogen viral, bacterial, fungal, protozoan, or helminthic in any location of the body may be associated with the use of corticosteroids alone or in combination with other immunosuppressive agents. At endpoint the protocol-specified time of outcome assessment there was a statistically significant reduction in muscle tone and frequency of spasms in the Zanaflex treated group compared to placebo. The reduction in muscle tone was not associated with a reduction in muscle strength a desirable outcome but also did not lead to any consistent advantage of Zanaflex treated patients on measures of activities of daily living. Figure 3 below shows a comparison of the mean change in muscle tone from baseline as measured by the Ashworth scale. Because of potential drug interactions, concomitant use of Zanaflex with other CYP1A2 inhibitors, such as zileuton, fluoroquinolones other than strong CYP1A2 inhibitors which are contraindicated antiarrythmics amiodarone, mexiletine, propafenone, and verapamil cimetidine, famotidine, oral contraceptives, acyclovir, and ticlopidine should be avoided. Lab tests, such as liver tests, may be performed while you use tizanidine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Take this medication with a full glass of water. Check with your pharmacist about how to dispose of unused medicine. Naturally occurring glucocorticoids hydrocortisone and cortisone which also have salt retaining properties, are used in replacement therapy in adrenocortical deficiency states. Their synthetic analogs are used primarily for their anti-inflammatory effects in disorders of many organ systems. Cholestyramine may increase the clearance of oral corticosteroids.
Treatment of acute overdosage is by supportive and symptomatic therapy. For chronic overdosage in the face of severe disease requiring continuous steroid therapy, the dosage of the corticosteroid may be reduced only temporarily, or alternate day treatment may be introduced. Gilenya fingolimod US prescribing information. Bradycardia-Causing Agents: May enhance the bradycardic effect of other Bradycardia-Causing Agents. Tizanidine may cause drowsiness, dizziness, light-headedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use tizanidine with caution. Take this medication by mouth with or without food as directed by your doctor. The dosage is based on your medical condition and response to treatment. When you first start taking this medication, you will usually take it once daily. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Once your dose increases to more than 5 milligrams per day, take this medication twice daily or as directed by your doctor. Granfors MT, Backman JT, Neuvonen M, Ahonen J, Neuvonen PJ. Fluvoxamine drastically increases concentrations and effects of tizanidine: a potentially hazardous interaction. Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce adult dose of CNS depressant agents by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established. Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose. See the causes of joint pain and how to treat it with both home remedies and prescribed medication. Zanaflex has not been studied in pregnant women. Zanaflex therapy is clinically evident. Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently. Convulsions have been reported with concurrent use. Hypersensitivity reactions: Hypersensitivity reactions, including anaphylaxis, angioedema, respiratory compromise, and urticaria have been reported with use. Patients with signs and symptoms of allergic reactions should discontinue therapy. mebendazole price in america
Response was assessed by physical examination; muscle tone was rated on a 5 point scale Ashworth score with a score of 0 used to describe normal muscle tone. A score of 1 indicated a slight spastic catch while a score of 2 indicated more marked muscle resistance. A score of 3 was used to describe considerable increase in tone, making passive movement difficult. A muscle immobilized by spasticity was given a score of 4. Spasm counts were also collected. These doctors are trained to help with pain that doesn't respond to medicines or usual treatments. Ultane sevoflurane US prescribing information. AbbVie, Inc. The lowest possible dose of corticosteroid should be used to control the condition under treatment. When reduction in dosage is possible, the reduction should be gradual. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Zanaflex tizanidine is a muscle relaxant used to treat muscle tightness and cramping spasm caused by conditions such as or spinal injury. Zanaflex cannot be entirely excluded. Other: Abnormal fat deposits, decreased resistance to infection, hiccups, increased or decreased motility and number of spermatozoa, injection site infections following non-sterile administration see malaise, moon face, weight gain. Zanaflex should be used with caution in patients with any hepatic impairment. In these patients, during titration, the individual doses should be reduced. If higher doses are required, individual doses rather than dosing frequency should be increased. Monitoring of aminotransferase levels is recommended for baseline and 1 month after maximum dose is achieved, or if hepatic injury is suspected. Corticosteroids can produce reversible HPA axis suppression with the potential for glucocorticosteroid insufficiency after withdrawal of treatment. Drug induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Ciprofloxacin may slow down how quickly your liver processes tizanidine. CNS depressants is not recommended. Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. QTdrugs List, AZCERT, Inc. Beta-Blockers: Alpha2-Agonists may enhance the AV-blocking effect of Beta-Blockers. Sinus node dysfunction may also be enhanced. Beta-Blockers may enhance the rebound hypertensive effect of Alpha2-Agonists. This effect can occur when the Alpha2-Agonist is abruptly withdrawn. Management: Closely monitor heart rate during treatment with a beta blocker and clonidine. Withdraw beta blockers several days before clonidine withdrawal when possible, and monitor blood pressure closely. Recommendations for other alpha2-agonists are unavailable. Exceptions: Levobunolol; Metipranolol. Remember that your doctor has prescribed this because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Bretylium: May enhance the bradycardic effect of Bradycardia-Causing Agents. Bretylium may also enhance atrioventricular AV blockade in patients receiving AV blocking agents. Clinical studies of Zanaflex did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently than younger subjects. Cross-study comparison of pharmacokinetic data following single dose administration of 6 mg Zanaflex showed that younger subjects cleared the drug four times faster than the elderly subjects. In addition, hypotension and bradycardia were observed. The occurrence of these reactions is summarized in Table 2. Other events were, in general, reported at a rate of 2% or less. Younger subjects cleared drug 4 times faster than elderly subjects. Depo-Medrol Sterile Aqueous Suspension contains methylprednisolone acetate which is the 6-methyl derivative of prednisolone. Patients should be advised not to abruptly stop taking this medication without first talking with their healthcare provider. Tapentadol: May enhance the CNS depressant effect of CNS Depressants. Management: Avoid concomitant use of tapentadol and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose. Animal studies in which corticosteroids have been given to pregnant mice, rats, and rabbits have yielded an increased incidence of cleft palate in the offspring. There are no adequate and well-controlled studies in pregnant women. Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. Body aches, dizziness, constipation, and headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Zanaflex be used with other α2- adrenergic agonists. Luvox fluvoxamine maleate US prescribing information. ANI Pharmaceuticals November, 2012. Switching between tizanidine tablets and capsules, or changing the way you take it with regard to eating, can cause an increase in side effects or a decrease in therapeutic effect. Follow your doctor's instructions carefully. After making any changes in how you take tizanidine, contact your doctor if you notice any change in how well the medicine works or if it causes increased side effects. latisse cost in singapore
Granfors MT, Backman JT, Laitila J, Neuvonen PJ. Tizanidine is mainly metabolized by cytochrome p450 1A2 in vitro. Flunitrazepam: CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. Tizanidine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Dizziness is most likely to occur when you rise from a sitting or lying position. Get up slowly to prevent dizziness and a possible fall. There is an enhanced effect due to decreased metabolism of corticosteroids in patients with cirrhosis. If a local anesthetic is used prior to injection of Depo-Medrol, the anesthetic package insert should be read carefully and all the precautions observed.
Following oral administration, tizanidine is essentially completely absorbed. Zanaflex is a central alpha-2-adrenergic agonist indicated for the management of spasticity. Before using methocarbamol, tell your doctor if you regularly use other medicines that make you sleepy such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety. They can add to sleepiness caused by methocarbamol. When two 4 mg tablets were administered with food, the mean maximal plasma concentration was increased by approximately 30%, and the median time to peak plasma concentration was increased by 25 minutes, to 1 hour and 25 minutes. In contrast, when two 4 mg capsules were administered with food, the mean maximal plasma concentration was decreased by 20%, the median time to peak plasma concentration was increased 2 to 3 hours. Consequently, the mean C max for the capsule when administered with food is approximately 66% the C max for the tablet when administered with food. Zanaflex be used with other α2-adrenergic agonists. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Cipralex escitalopram oxalate UK summary of product characteristics. If you have any of these conditions, you may not be able to use tizanidine, or you may need a dosage adjustment or special tests during treatment. Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Physical therapy PT involves treatments that focus on prevention and management of injuries or disabilities. PT helps to relieve pain, promote healing, and restore function and movement. Table 1 lists signs and symptoms that were reported in greater than 2% of patients in three multiple dose, placebo-controlled studies who received Zanaflex where the frequency in the Zanaflex group was greater than the placebo group. For comparison purposes, the corresponding frequency of the event per 100 patients among placebo treated patients is also provided. Many people have some curve in their spine. Make sure laboratory personnel and all your doctors know you use this medication. Allergic States: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, seasonal or perennial allergic rhinitis, serum sickness, transfusion reactions. The tablets have a quadrisecting score on one side and are debossed with "A594" on the other side. Tablets are provided as follows: bottles of 150 tablets NDC 10144-594-15. etodolac
Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Side Effects List Tizanidine HCL side effects by likelihood and severity. Metabolic: Negative nitrogen balance due to protein catabolism. Marketed and Distributed by: Acorda Therapeutics Inc. This product, like many other steroid formulations, is sensitive to heat. Therefore, it should not be autoclaved when it is desirable to sterilize the outside of the vial. Votrient pazopanib US prescribing information. Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. It is recommended that latent amebiasis or active amebiasis be ruled out before initiating corticosteroid therapy in any patient who has spent time in the tropics or in any patient with unexplained diarrhea. Tablets and capsules are bioequivalent under fasting conditions, but not under nonfasting conditions. During titration, the individual doses should be reduced. If higher doses are required, individual doses rather than dosing frequency should be increased. Monitor elderly patients because they may have an increased risk for adverse reactions associated with Zanaflex. Multidose use of Depo-Medrol Sterile Aqueous Suspension from a single vial requires special care to avoid contamination. Although initially sterile, any multidose use of vials may lead to contamination unless strict aseptic technique is observed. Particular care, such as use of disposable sterile syringes and needles, is necessary. Rare Disease Database under "Rare Disease Information". Moderate Risk QTc-Prolonging Agents: QTc-Prolonging Agents Indeterminate Risk and Risk Modifying may enhance the QTc-prolonging effect of Moderate Risk QTc-Prolonging Agents. How should I take methocarbamol? Phansalkar S, Desai AA, Bell D, Yoshida E, Doole J, Czochanski M, Middleton B, Bates DW. High-priority drug-drug interactions for use in electronic health records.
It is recommended that the anatomy of the joint involved be reviewed before attempting intra-articular injection. In order to obtain the full anti-inflammatory effect, it is important that the injection be made into the synovial space. Employing the same sterile technique as for a lumbar puncture, a sterile 20 to 24 gauge needle on a dry syringe is quickly inserted into the synovial cavity. Procaine infiltration is elective. The aspiration of only a few drops of joint fluid proves the joint space has been entered by the needle. The injection site for each joint is determined by that location where the synovial cavity is most superficial and most free of large vessels and nerves. With the needle in place, the aspirating syringe is removed and replaced by a second syringe containing the desired amount of Depo-Medrol. The plunger is then pulled outward slightly to aspirate synovial fluid and to make sure the needle is still in the synovial space. After injection, the joint is moved gently a few times to aid mixing of the synovial fluid and the suspension. The site is covered with a small sterile dressing. Started taking two weeks ago only 2mg. at bedtime, but that didn't help my TMD muscle spasms in daytime so last week Dr. had me taking 2mg. at 10am, 4pm and 4mg at bedtime. After second day I started waking up around 6am with chills and nervous stomach, but continued schedule for a week. Last night I cut back bedtime dose to 2mg. Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Tell patients to take Zanaflex 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. Taking two or more medicines that can affect your heart rhythm may increase your risk of irregular heartbeat, which may be life-threatening. How often did hospital staff describe possible side effects in a way you could understand? What should I avoid while taking tizanidine Zanaflex? In a 7-week study Study 2 118 patients with spasticity secondary to spinal cord injury were randomized to either placebo or Zanaflex. Steps similar to those taken in the first study were employed to ensure the integrity of blinding. Certain events, such as somnolence, dry mouth, hypotension, decreased blood pressure, bradycardia, dizziness, weakness or asthenia, muscle spasms, hallucinations, fatigue, liver function test abnormality and hepatotoxicity, have been observed in post marketing and clinical trials and are discussed in previous sections of this document. Tell your doctor when you start any new drug, and discuss if you should use additional reliable birth control. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well. Blonanserin: CNS Depressants may enhance the CNS depressant effect of Blonanserin. CNS depressants. Remind patients that if they depend on their spasticity to sustain posture and balance in locomotion, or whenever spasticity is utilized to obtain increased function, that Zanaflex decreases spasticity and caution should be used. buy ceclor london over counter
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Let your doctor know if you notice an irregular heartbeat or have any fainting or dizziness. Your doctor may want to change your medicine. Use caution when performing tasks that require alertness. The recommended starting dose is 2 mg. Because the effect of Zanaflex peaks at approximately 1 to 2 hours post-dose and dissipates between 3 to 6 hours post-dose, treatment can be repeated at 6 to 8 hour intervals, as needed, to a maximum of three doses in 24 hours. PREGNANCY and BREAST-FEEDING: It is not known if tizanidine can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using tizanidine while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use tizanidine, check with your doctor. Discuss any possible risks to your baby. brand ciprofloxacin capsules ciprofloxacin
Orphenadrine: CNS Depressants may enhance the CNS depressant effect of Orphenadrine. Started taking two weeks ago only 2mg. at bedtime, but that didn't help my TMD muscle spasms in daytime so last week Dr. had me taking 2mg. at 10am, 4pm and 4mg at bedtime. After second day I started waking up around 6am with chills and nervous stomach, but continued schedule for a week. Last night I cut back bedtime dose to 2mg. and didn't feel as bad this morning and I'm only going to take 2mg in afternoon and 2mg. at bedtime tonight. Gradual dose reduction is advised on discontinuation so as to minimize risk of withdrawal and rebound hypertension, tachycardia, and hypertonia.
In most cases, the cause of scoliosis is not known. Scoliosis usually starts in the preteen years. Scoliosis that is severe enough to need treatment is most common in girls. Tell your doctor about all other medicines you use, especially pyridostigmine Mestinon. Do not stop taking any medications without consulting your healthcare provider. What Is Tizanidine and How Does It Work? Nervous System: Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor or craniotomy. igow.info furosemide
Consult WARNINGS section for additional precautions. Memantine is used to treat moderate to severe confusion dementia related to Alzheimer's disease. It does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to perform daily functions. This medication works by blocking the action of a certain natural substance in the brain glutamate that is believed to be linked to symptoms of Alzheimer's disease. In the treatment of conditions such as tendinitis or tenosynovitis, care should be taken following application of a suitable antiseptic to the overlying skin to inject the suspension into the tendon sheath rather than into the substance of the tendon. The tendon may be readily palpated when placed on a stretch. When treating conditions such as epicondylitis, the area of greatest tenderness should be outlined carefully and the suspension infiltrated into the area. For ganglia of the tendon sheaths, the suspension is injected directly into the cyst. In many cases, a single injection causes a marked decrease in the size of the cystic tumor and may effect disappearance. The usual sterile precautions should be observed, of course, with each injection.