I take Tramadol and Zanaflex for pain control. My dosage of Zanaflex is 4mg a day which I have been on for 1 1/2 yrs. I get blood work done twice a year to check my liver enzymes. Last week I had blood drawn and within a 6 month time frame my levels have increased to a highly elevated level. (5 times higher than the normal range) I have heard that Zanaflex is not so good on the liver, but I thought that was at higher levels than 4mg a day. The doctor wants me to come in for more blood work and an ultrasound of my liver. He said it may even be hepatitis which scares the heck out of me.