Baclofen

Indications
 Oral
Severe chronic spasticity
Adult: Initially, 5 mg tid for 3 days increased to 10 mg tid for 3 days, then in similar increments and intervals until either 20 mg tid is reached or until desired effect is obtained. Max: 100 mg daily.
Child: 0.75-2 mg/kg daily. May initiate with 2.5 mg 4 times daily, increased gradually every 3 days until desired effect is obtained. Maintenance: 6-10 yr: 30-60 mg daily; 2-6 yr: 20-30 mg daily; 12 mth-2 yr: 10-20 mg daily. Max: >10 yr: 2.5 mg/kg daily.
Elderly: Initiate with lower doses.
Renal impairment: Dose reduction may be required. Patients on chronic haemodialysis: 5 mg daily.
Intrathecal
Severe chronic spasticity
Adult: Test dose: 25 or 50 mcg administered into the intrathecal space by barbotage over at least 1 minute; increase dose by 25 mcg not more often than every 24 hr until 100 mcg/dose to determine appropriate dose. Non-responders to a test dose of 100 mcg are not suitable for intrathecal treatment. For responders with response lasting >8-12 hr, the test dose that was used to produce the response can be given as a 24-hr infusion; if the test-dose response lasted ≤8-12 hr, then a dose equivalent to twice the test dose is given. Adjust daily dosage as required. Maintenance: 12 mcg-2 mg daily for spasticity of spinal origin; 22 mcg-1.4 mg daily for spasticity of cerebral origin.
Child: 4-18 yr with spasticity of cerebral origin: Initially, 25 mcg over at least 1 minute via catheter or lumbar puncture, increase by 25 mcg every 24 hr to a max of 100 mcg to determine appropriate dose then dose-titration phase. Maintenance: <12 yr: 24 mcg-1.2 mg daily; >12 yr: 1.4 mg daily.
Contraindications
 Hypersensitivity. Active peptic ulcer disease.
Warnings / Precautions
 Cerebrovascular disorders, epilepsy, severe psychotic disorders, confusional states, history of peptic ulcer, resp depression, diabetes (DM), hepatic or renal impairment, elderly, pregnancy. Avoid sudden withdrawal.
Adverse Reactions
 Sedation, drowsiness, ataxia, dizziness, headache, confusion, hallucinations, skin reactions, GI symptoms, enuresis.
Potentially Fatal: Respiratory or CV depression, seizures.
Overdose Reactions
 Symptoms include muscular hypotonia, drowsiness, respiratory depression, coma and convulsions. Gastric lavage may be used.
Drug Interactions
 Hypotensive effect may be increased with antihypertensives. Concomittant use with levodopa in Parkinson patients may result in confusion, agitation, hallucinations.
Potentially Fatal: CNS depressants and alcohol may potentiate CNS effects.
See Below for More baclofen Drug Interactions
Mechanism of Actions
 Baclofen is an antispastic. It inhibits both monosynaptic and polysynaptic reflexes at spinal level.
Absorption: Rapidly and almost completely absorbed from GIT (oral); peak plasma conc after 1-3 hr.
Distribution: Blood-brain barrier, CSF (equivalent to 12% conc found in plasma). Protein-binding: 30%.
Metabolism: Hepatic (15% of the dose).
Excretion: Via urine (70-80% as unchanged drug); elimination half-life (Via urine (70-80% as unchanged drug); elimination half-life (t1/2): 3-4 hr (plasma), 5 hr (CSF). 3-4 hr (plasma), 5 hr (CSF).
Administration
 Should be taken with food.
Storage Conditions
 Oral: Store below 25°C.
ATC Classification
 M03BX01 - baclofen ; Belongs to the class of other centrally-acting muscle relaxants.
Storage
 Oral: Store below 25°C.
Available As
  • Baclofen 0.05 mg
  • Baclofen 0.5 mg
  • Baclofen 10 mg
  • Baclofen 20 mg
  • Baclofen 25 mg
  • Baclofen 30 mg
  • Baclofen 40 mg
  • Baclofen 5 mg
  • Baclofen 50 mg
  • Baclofen 500 mg

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