Drug Index

Baclofen

 
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Mechanism :

Baclofen is a muscle relaxant and antispastic. It is derived from gamma-aminobutyric acid (GABA). The mechanism of action of baclofen is not known precisely. Baclofen is capable of inhibiting both monosynaptic and polysynaptic reflexes at the spinal level, possibly by hyperpolarization of afferent terminals, although actions at supraspinal sites may also occur and contribute to its clinical effect.


Indication :

• Spasticity resulting from multiple sclerosis, cerebral palsy, neurodegenerative diseases


Contraindications :

Hypersensitivity to baclofen.


Dosing :

Spasticity: Oral

≥4 months-7 years: 10 to 15 mg daily divided doses every 8 hourly; begin at low dose of 2.5 mg daily and titrate dose every 3rd day according to patient response.

8-11 years: 10 to 40 mg daily divided doses every 8 hourly, begin at low end of range and titrate dose.

>12 years: 20-60 mg daily divided every 8 hours; begin at low end of range and titrate dose.

Spasticity: Intrathecal (<4 years: Safety and efficacy not established)

Test bolus: 50 mcg intrathecal over 1 minute; if inadequate response within 8 hours, 75 mcg 24 hours later; if still inadequate, 100 mcg 24 hours later. (Patients who do not respond to a 100 mcg intrathecal bolus should not be considered candidates for an implanted pump for chronic infusion. Initial implant dose: 2 times screening dose that gave positive effect, administer over 24 hours period. After the first 24 hours, the daily dose should be increased slowly by 5-15% only once every 24 hours, until desired clinical effect is achieved).


Adverse Effect :

Confusion, headache, insomnia, euphoria, excitement, depression, hallucinations, paresthesia, muscle pain, tinnitus, slurred speech, coordination disorder, tremor, rigidity, dystonia, ataxia, blurred vision, nystagmus, strabismus, miosis, mydriasis, diplopia, dysarthria, epileptic seizure, hypotension, dyspnea, palpitation, chest pain, syncope, nausea, constipation, dry mouth, anorexia, taste disorder, abdominal pain, vomiting, diarrhea, and positive test for occult blood in stool, urinary frequency, urinary retention, dysuria, impotence, inability to ejaculate, nocturia, hematuria, rash, pruritus, excessive perspiration.


Interaction :

Anti-hypertensives: Enhanced hypotensive effect.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-505 mg, 3 times a day and titrate according to response
10-205 mg, twice a day and titrate according to response
<105 mg, once a day and titrate according to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as in GFR<10 mL/min
HDDialysed. Dose as in GFR<10 mL/ min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDUnknown dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

No dosage adjustments are recommended.
07/28/2020 02:13:43 Baclofen
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