View source for Baclofen

==Administration==
*Type: Muscle relaxant/anti-spasmodic
*Dosage Forms: tablet, intrathecal solution, preservative free intrathecal solution
*Dosage Strengths: tablet: 10, 20mg; intrathecal solution: 50, 500mcg/mL; preservative free intrathecal solution: 500, 1000, 2000 mcg/mL
*Routes of Administration: oral, intrathecal
*Common Trade Names: Lioresal, Gablofen

==Adult Dosing==
*5-20mg PO 3-4 times/day
*maintenance intrathecal rate after titration: 22 to 1400 mcg/day 

==Pediatric Dosing==
*2-7yo: 10 to 15 mg/day PO in 2-3 divided doses, titrate to max 40mg/day in 3-4 divided doses
*>7 yo: 10 to 15 mg/day PO in 2-3 divided doses, titrate to max 60mg/day in 3-4 divided doses
*<12 yo: maintenance intrathecal rate after titration- 24 to 1199 mcg/day 

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Lactation risk categories|Lactation risk]]: Infant risk minimal
===Renal Dosing===
*CrCl 50-80 mL/min: reduce dose by 1/3
*CrCl 30-50 mL/min: reduce dose by 1/2
*CrCl <30 mL/min: reduce dose by 2/3
*If HD, use intrathecal with caution, likely reduce dose
===Hepatic Dosing===
*No adjustment

==Contraindications==
*Allergy to class/drug

==Adverse Reactions==
===Serious===
*GI bleed
*Coma
*Seizure
*Aseptic meningitis
*Pneumonia
*Withdrawal
===Common===
*Hypotension
*Nausea/vomiting, constipation
*Dizziness, somnolence, asthenia, poor muscle tone
*Urinary complications
==Pharmacology==
*Half-life: 5 hours (oral), 1.5-4 hours (intrathecal)
*Metabolism: Hepatic (15%)
*Excretion: Mostly renal

==Mechanism of Action==
*GABA-B agonist

==Comments==

==See Also==
*[[Baclofen toxicity]]
*[[Baclofen withdrawal]]

==References==
*Abarbanel J, Herishanu Y, Frisher S, “Encephalopathy Associated With Baclofen,” Ann Neurol, 1985, 17(6):617-8. [PubMed 4026235]
*Addolorato G, Leggio L, Ferrulli A, et al. Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomized, double-blind controlled study. Lancet. 2007;370:1915-1922. [PubMed 18068515]
*Agarwal SK, Kriel RL, Cloyd JC, et al. A pilot study assessing pharmacokinetics and tolerability of oral and intravenous baclofen in healthy adult volunteers. J Child Neurol. 2015;30(1):37-41. [PubMed 25028414]10.1177/0883073814535504
*Aisen ML, Dietz M, McDowell F, Kutt H. Baclofen toxicity in a patient with subclinical renal insufficiency. Arch Phys Med Rehabil. 1994;75(1):109-111. [PubMed 8291951]
*Albright AL, “Baclofen in Treatment of Cerebral Palsy,” J Child Neurol, 1996, 11(2):77-83. [PubMed 8881981]
*Anderson PO, Sauberan JB. Modeling drug passage into human milk. Clin Pharmacol Ther. 2016;100(1):42-52. [PubMed 27060684]
*ASHP. Standardize 4 Safety Initiative Compounded Oral Liquid Version 1.01. July 2017. https://www.ashp.org/-/media/assets/pharmacy-practice/s4s/docs/s4s-ashp-oral-compound-liquids.ashx?la=en&hash=4C2E4F370B665C028981B61F6210335AD5D0D1D6.
*Averbuch-Heller L, Tusa RJ, Fuhry L, et al. A double-blind controlled study of gabapentin and baclofen as treatment for acquired nystagmus. Ann Neurol. 1997;41(6):818-825. [PubMed 9189045]
*Baclofen tablet [prescribing information]. Pulaski, TN: AvKare Inc; April 2014.
*Brunton LL, Chabner BA, Knollmann BC, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 12th ed. New York, NY: McGraw-Hill Medical; 2011.

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[[Category:Pharmacology]]