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HomeAnswersFamily Physicianmedicine side effectsI have extreme shaking and severe weakness. Why?

What causes the feeling of shaky, clammy, and flushing?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At March 6, 2017
Reviewed AtApril 22, 2024

Patient's Query

Hi doctor,

I am 46 years old. My weight is 147 lbs and height is 5 feet 3 inches. I am currently taking Tizanidine, Nabumetone, and Hydrocodone as prescribed for a back injury sustained over three years ago. My symptoms are extreme shaking, severe weakness sometimes to the point of feeling like I am about to pass out, nausea, vomiting, clammy, incredibly sweating and flushing. It happens about two to six times a day for a week and then goes away for roughly one to three weeks. I would like to know the reason for those symptoms. Should I visit my doctor immediately?


Welcome to icliniq.com.

I have gone through your query, and I can understand your concerns.

I think you had a back injury, pain, and spasticity (stiffness) for which you are taking the above mentioned drugs for last three years. Let me explain briefly about the drugs you are taking. Nabumetone is a relatively safe drug and side effects are very minimal apart from mild gastritis and nausea.

Tizanidine is a muscle relaxant, and it is used for stiffness. Long-term use of Tizanidine for years can cause some adverse effects like dizziness, vomiting, extreme fatigue, confusion, etc. So, your symptoms can be due to adverse effects of Tizanidine.

Hydrocodone is an analgesic and is used for pain conditions. The side effects are similar to Tizanidine. Your problems could be due to the side effects of your pain medicines. But before making a definite diagnosis, we have to rule out some other condition.

I suggest you consult a general practitioner and do the following to rule out some other condition which can have symptoms similar as in your history.

  1. ECG to rule out coronary artery disease.
  2. Serum electrolyte assay to rule out hypokalemia and hyponatremia.
  3. Check your blood pressure level to rule out hypotension and hypertension.
  4. Check your blood sugar level.
  5. All other investigations as prescribed by your treating physician which might include a CT head and upper GI endoscopy.
  6. As of now, you can do the following the following:

    Drink plenty of water, avoid unwanted stresses be calm and relaxed, get adequate sleep and healthy diet and consult your doctor for nausea and vomiting.

The Probable causes

Adverse drug reactions.

Investigations to be done

ECG, serum electrolytes, RBS (random blood sugar) and CT head.

Differential diagnosis

1. Coronary artery disease.

2. Electrolyte imbalance.

Treatment plan


Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shinas Hussain A. P
Dr. Shinas Hussain A. P

General Practitioner

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