Admitted to a NACTN hospital

Inclusion Criteria:

• Age equal to or greater than 18 years and less than or equal to 70 years;
• Willing to give written informed consent to participate in the study. The informed consent may require legally authorized representative to sign if arm/hand function is compromised.
• No other life-threatening injury
• Spinal cord injury at the neurologic level from C4 to T12
• ASIA Impairment Scale level A, B or C
• No cognitive impairment which would preclude an informed consent (including moderate or severe traumatic brain injury)
• Less than 12 hours since injury

Exclusion Criteria:

• Equal or more than 12 hours since injury
• Hypersensitivity to riluzole or any of its components
• Unable to receive riluzole orally or via NG tube
• History of liver or kidney disease (e.g. Hepatitis A, B or C, Cirrhosis, etc.)
• Has a recent history of regular substance abuse (illicit drugs, alcohol)
• Unconscious
• Penetrating spinal cord injury
• Pregnancy as established by urine pregnancy test
• Breastfeeding
• Life expectancy less than 12 months
• Is currently involved in another therapeutic SCI research study that precludes or complicates participation in this study (e.g. study of another therapeutic drug aiming for spinal cord injury recovery, any study that substantially interferes with the follow -up schedule (f/u) schedule, or any high risk study that complicates evaluation of safety outcomes. Types of studies that would not preclude participation are e.g. behavioral adaptation studies, mental health interventions)
• Has a mental disorder or other illness, which in the view of the site investigator, would preclude accurate evaluation (e.g. schizophrenia, severe cognitive disability, Parkinson disease)
• Unable to commit to the follow-up schedule
• Is a prisoner
• Unable to converse, read or write English at the elementary school level