Baclofen(bak’ loe fen)
Apo-Baclofen (CAN), Gablofen, Gen-Baclofen, (CAN), Kemstro, Lioresal, Lioresal Intrathecal, PMS-Baclofen (CAN), ratio-Baclofen (CAN)
PREGNANCY CATEGORY C
Drug class
Centrally acting skeletal muscle relaxant
Therapeutic Actions
Precise mechanism not known; GABA analogue but does not appear to produce clinical effects by actions on GABA-minergic systems; inhibits both monosynaptic and polysynaptic spinal reflexes; CNS depressant.
Indications
Alleviation of signs and symptoms of spasticity resulting from MS, particularly for the relief of flexor spasms and concomitant
pain, clonus, muscular rigidity (for patients with reversible spasticity to aid in restoring residual function); treatment of severe spasticity (intrathecal route)
Spinal cord injuries and other spinal cord diseases—may be of some value (oral)
Unlabeled uses: Trigeminal neuralgia (tic douloureux); may be beneficial in reducing spasticity in cerebral palsy in children (intrathecal use); intractable hiccups unresponsive to other therapies, alcohol and opiate withdrawal (oral), GERD, migraine prevention
Contraindications and Cautions
Contraindicated with hypersensitivity to baclofen; skeletal muscle spasm resulting from rheumatic disorders.
Use cautiously with stroke, cerebral palsy, Parkinson’s disease, seizure disorders, lactation, pregnancy.
Available Forms
Tablets—10, 20 mg; intrathecal—0.05 mg/mL, 2 mg/mL, 10 mg/20 mL, 10 mg/5 mL
Dosages
Adults
Oral
Individualize dosage; start at low dosage and increase gradually until optimum effect is achieved (usually 40–80 mg/day). The following dosage schedule is suggested: 5 mg PO tid for 3 days; 10 mg tid for 3 days; 15 mg tid for 3 days; 20 mg tid for 3 days. Thereafter, additional increases may be needed, but do not exceed 80 mg/day (20 mg qid); use lowest effective dose. If benefits are not evident after a reasonable trial period, gradually withdraw the drug.
Intrathecal
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