Generic Name and Formulations:
Baclofen 50mcg/mL, 500mcg/mL, 1000mcg/mL, 2000mcg/mL; for intrathecal inj; preservative-free.
Severe spasticity of cerebral or spinal origin, when oral baclofen is not appropriate.
<4yrs: not established. ≥4yrs: Give test dose 1st by intrathecal inj via spinal catheter or lumbar puncture (see full labeling for dose and timing; use 50mcg/mL syringe). Dose titration: see full labeling. Maintenance: titrate individually; use lowest effective dose; maintain some degree of muscle tone. Spinal cord origin: usually 300–800mcg/day. Cerebral origin: usually 90–700mcg/day (24–1199mcg/day in <12yrs). Avoid abrupt cessation (may be severe/fatal); closely monitor pump, alarms, and refill schedule; wean orally-administered antispasticity drugs carefully.
Not for IV, IM, SC or epidural administration.
Abrupt discontinuation may result in high fever, altered mental status, rebound spasticity, muscle rigidity; avoid. Apparent risk patients (eg, spinal cord injury at T-6 or higher, communicative impairment, history of withdrawal symptoms): closely monitor infusion system, dosing schedule, refills, pump alarms, clinical signs of withdrawal or overdose. Avoid use of prefilled syringe in an aseptic setting to fill pumps prior to implantation. Supervise 1st dose, during titration and refills; have resuscitative equipment and trained personnel available. Do not use chronically if test dose ineffective. For chronic dosing use approved pump (eg, Medtronic SynchroMed II Programmable). Allow at least one year after traumatic brain injury before starting. Psychosis. Schizoaffective disorders. Confusion. Autonomic dysreflexia. Infections. Hospitalize immediately if pump malfunction suspected. Pregnancy (Cat.C). Nursing mothers: not recommended.
Hypotension, dyspnea with morphine. Additive CNS depression with alcohol, other CNS depressants. Do not mix with other drugs in pump or catheter. Physostigmine may be useful in reversing effects (see full labeling).
Muscle relaxant (central), antispastic agent.
Hypotonia, somnolence, dizziness, paresthesia, nausea, headache, constipation, convulsion, hypotension, coma, drowsiness, psychosis, confusion, agitation, leukocytosis, chills, urinary retention; CNS depression, cardiovascular collapse, respiratory failure; others.
Prefilled syringes (50mcg/1mL, 10000mcg/20mL, 20000mcg/20mL, 40000mcg/20mL)—1; Vials (10000mcg/20mL, 20000mcg/20mL, 40000mcg/20mL)—1
Join MIMS Learning now to manage all your CPD and notes in one place!
Already a MIMS Learning member?Sign In Now »
This red flags article explains signs and symptoms of potentially serious pathology in patients presenting...
This article by Dr Tillmann Jacobi covers the possible red flag symptoms to consider when a patient...
Dr Suneeta Kochhar provides an overview of red flag symptoms in patients presenting with headaches...
In this article, Dr David Brass and Dr Neil Rajan discuss the risk factors for BCC, making the diagnosis...
This article by Dr Rajiv Sankaranarayanan covers the diagnosis and management of cardiomyopathy. Key...
Dr Benjamin Simpson provides an in-depth overview of Parkinson’s disease, including information on risk...