Baclofen, brand name Lioresal, is a muscle relaxant and antispastic. Baclofen tablets are available as 25 mg tablets for oral administration.
Lioresal, baclofen, is used to relieve the muscle spasms, pain, and muscular rigidity associated with multiple sclerosis.
The precise mechanism of action of baclofen as a muscle relaxant and antispasticity agent is not fully understood. Baclofen inhibits both monosynaptic and polysynaptic reflexes at the spinal level, although actions at supraspinal sites may also occur and contribute to its clinical effect.
Baclofen may also be of some value in patients with spinal cord injuries and other spinal cord diseases.
Lioresal is not indicated in the treatment of skeletal muscle spasm resulting from rheumatic disorders.
Lioresal comes as a tablet, 25 mg, to take by mouth. Baclofen absorption is not affected by food, but baclofen should be taken with a meal to minimize stomach upset.
The determination of optimal dosage requires individual titration. Start the therapy with Lioresal at a low dosage and increase gradually until optimum effect is achieved (usually between 40-80 mg daily).
The following dosage schedule is suggested:
5 mg. t.i.d. for 3 days
10 mg. t.i.d. for 3 days
15 mg. t.i.d. for 3 days
20 mg. t.i.d. for 3 days
Thereafter additional increases may be necessary but the total daily dose should not exceed a maximum of 80 mg daily (20 mg. q.i.d.).
The lowest dose of baclofen compatible with an optimal response is recommended. If benefits are not evident after a reasonable trial period, patients should be slowly withdrawn from baclofen.
If you miss a dose, take it as soon as remembered if it is within an hour or so. If you do not remember until later, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.
Because of the possibility of sedation, patients should be cautioned regarding the operation of automobiles or other dangerous machinery, and activities made hazardous by decreased alertness. Patients should also be cautioned that the central nervous system effects of baclofen may be additive to those of alcohol and other CNS depressants.
Baclofen should be used with caution where spasticity is utilized to sustain upright posture and balance in locomotion or whenever spasticity is utilized to obtain increased function.
In patients with epilepsy, the clinical state and electroencephalogram should be monitored at regular intervals, since deterioration in seizure control and EEG have been reported occasionally in patients taking baclofen.
Because baclofen is primarily excreted unchanged through the kidneys, it should be given with caution, and it may be necessary to reduce the dosage, in individuals with impaired renal function.
Safe use of baclofen in children under 12 has not been established, and it is, therefore, not recommended for use in children.
Baclofen should be used during pregnancy only if the benefit clearly justifies the potential risk to the fetus.
Baclofen is, when taken orally, excreted in human milk why nursing while using baclofen is not recommended.
Abrupt discontinuation: Special attention should be given to individuals at apparent risk (e.g. spinal cord injuries at T-6 or above, communication difficulties, history of withdrawal symptoms from oral or intrathecal baclofen). When appropriate, oral baclofen and/or diazepam rectal gel can be prescribed for emergency use.
Possible side effects
The most common side effects of the treatment with baclofen, are transient drowsiness, dizziness, weakness and fatigue. Other possible side effects include confusion, headache, insomnia and nausea.
If overdose of baclofen is suspected, contact your local poison control center or emergency room immediately.
Serious overdosage with baclofen may be characterized by vomiting, muscular hypotonia, drowsiness, accommodation disorders, coma, respiratory depression, and seizures.
Keep Lioresal in a tightly closed container and out of reach of children. Store Lioresal at room temperature and away from excess heat and moisture (not in the bathroom).
The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, or other healthcare professional. It should not be construed to indicate that use of baclofen is safe, appropriate, or effective for you.
Consult your health care professional before you