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Baclofen 💊
📖 About
Always check the BNF link here for up-to-date dosing and guidance.
- Baclofen is used for spasticity but has limited usefulness as side effects often outweigh benefits at higher doses.
- Efficacy increases with dose, but so does toxicity - titration must be cautious.
⚙️ Mechanism of Action
- GABA-B receptor agonist (presynaptic) → reduces excitatory neurotransmitter release.
- Decreases muscle tone by inhibiting spinal reflexes.
- Not effective for acute painful muscle spasm after injury (e.g. back strain).
🎯 Indications
- Generalised spasticity due to:
- Multiple sclerosis 🧠
- Transverse myelitis
- Stroke sequelae 🧩
- Spinal cord myelopathies
- Not indicated for short-lived musculoskeletal spasm (e.g. after trauma).
💊 Dosing – Baclofen (Oral)
| Step | Details |
|---|---|
| Start | Baclofen 5 mg TDS with food |
| Titration | Increase slowly to Baclofen 10 mg TDS as tolerated |
| Maximum | Usual max Baclofen 100 mg/day (side effects often limit benefit before this) |
| Special Populations | ⚠️ In elderly or renal impairment → start at ~50% dose and titrate carefully |
🔗 Interactions
- Enhanced sedation if combined with CNS depressants (benzodiazepines, opioids, alcohol).
- Increased risk of toxicity in renal impairment.
⛔ Contraindications / Cautions
- History of peptic ulceration (may ↑ gastric acid secretion).
- ⚠️ Advise patients not to drive or operate machinery if drowsy.
- Caution in epilepsy (may lower seizure threshold).
⚠️ Side Effects
- Common: drowsiness, confusion, fatigue 😴.
- GI upset: nausea, vomiting 🤢.
- At high doses: hypotonia, convulsions, dizziness.
- Abrupt withdrawal may cause rebound spasticity, hallucinations, seizures → taper slowly on discontinuation.
📚 References
- BNF – Baclofen
- Oxford Handbook of Clinical Medicine.
- NICE guidelines on spasticity in MS and neurological disorders.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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