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 BRAND NAMES
 MECHANISM OF ACTION
Baclofen depresses monosynaptic and polysynaptic reflex transmission at the spinal cord level, probably by various actions, including stimulation of GABAB-receptors. This stimulation in turn inhibits the release of excitatory amino acids, glutamate and aspartate, thereby relieving muscle spasticity
Suppression of voluntary muscle spasm in:
- Multiple sclerosis
- Spinal lesions of traumatic, infectious, degenerative, neoplastic and unknown origin, causing:
- skeletal hypertonus
- spastic and dyssynergic bladder dysfunction
Baclofen is not recommended in Parkinson's disease or spasticity arising from strokes, cerebral palsy or rheumatoid disorders.
Take Baclofen with food.
Adults: As a rule, treatment should be started with a dose of 5 mg three times daily, subsequently increased at 3-day intervals by 5 mg three times daily (i.e. the dosage regimen is 5 mg three times a day for 3 days, then 10 mg three times a day for 3 days, etc.) until the optimum response has been attained. The optimum dosage generally ranges from 30 mg to 75 mg daily, although occasionally in hospitalised patients daily doses up to 100 mg may be necessary.
Avoid abrupt withdrawl after prolonged use of baclofen because it may cause anxiety, hallucinations, tachycardia,or spasicity.
Known hypersensitivity to baclofen
 WARNINGS AND PRECAUTIONS
- Caution in patients with:
- Seizure disorder (Baclofen may cause deterioration of seizure control and may precipitate convulsions)
- Impaired renal function (a dosage reduction is advised to avoid drug accumulation), **Peptic ulcers (Baclofen stimulates gastric acid secretion)
- Diabetes mellitus (baclofen may increase blood glucose concentrations)
- Avoid abrupt withdrawl.
- Elderly are more sensitive to the effects of baclofen.
- May cause drowsiness or impaired judgment
- Levodopa o Levodopa/Carbidopa: In patients with Parkinson's disease receiving treatment with Baclofen and levodopa (alone or in combination with carbidopa), there have been reports of mental confusion, hallucinations, headaches, nausea and agitation. Worsening of the symptoms of Parkinsonism has also been reported. Hence, caution should be exercised during concomitant administration of Baclofen and levodopa/carbidopa (Sinemet).
- Drugs causing Central Nervous System depression (e.g. Opiate analgesics, benzodiazepines, other muscle relaxants such as tizanidine, alcohol): Increased sedation may occur
- Tricyclic antidepressants (TCAs): the effect of Baclofen may be potentiated, resulting in pronounced muscular hypotonia.
- Lithium: Concurrent use of oral Lioresal and lithium resulted in aggravated hyperkinetic symptoms. Thus, caution should be exercised when Lioresal is used concomitantly with lithium.
- Antihypertensives: Since concomitant treatment with antihypertensives is likely to enhance the fall in blood pressure, the dosage of antihypertensive medication should be adjusted accordingly
 PREGNANCY AND LACTATION
- Pregnancy Category C (US). Baclofen should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- Pregnancy Category B3 (Australia)
- Nursing mothers: In mothers treated with oral baclofen in therapeutic doses, the active substance passes into the breast milk. As a general rule, nursing should be undertaken while a patient is receiving Baclofen only if the potential benefit justifies the potential risks to the infant.
 SIDE EFFECTS
Possible adverse events include: Ataxia, drowsiness, Muscle weakness, insomnia, psychiatric disturbances, slurred speech, vertigo