BACLOFEN
(Lioresal)Standard Prescription
baclofen __mg PO Q_H (__mg/24hr)
Dosages
Dystonia
Initial: 0.1 mg/kg/dose PO TID
Titrate by 0.1-0.3 mg/kg/day every 3-7 days to effect
Target dose of 1-2 mg/kg/day
Spasticity
Children <2 yrs :
Initial: 2.5 mg PO once to TID
Titrate by 5 mg increments every 3-7 days to a maximum of 40 mg/24 hr
Titrate by 5 mg increments every 3-7 days to a maximum of 60 mg/24 hr
Titrate by 5 mg increments every 3-7 days to a maximum of 200 mg/24 hrs
Initial: 0.1 mg/kg/dose PO TID
Titrate by 0.1-0.3 mg/kg/day every 3-7 days to effect
Target dose of 1-2 mg/kg/day
Spasticity
Children <2 yrs :
Initial: 2.5 mg PO once to TID
Titrate by 5 mg increments every 3-7 days to a maximum of 40 mg/24 hr
2-7 yrs:
Initial: 2.5 mg PO once to TIDTitrate by 5 mg increments every 3-7 days to a maximum of 60 mg/24 hr
>8 years:
Initial: 5 mg PO once to TIDTitrate by 5 mg increments every 3-7 days to a maximum of 200 mg/24 hrs
Intrathecal
Usual maintenance: 100-2000 mcg/day (requires careful titration)Mechanism of Action
Skeletal muscle relaxant
Forms Supplied
Tablet: 10 mg, 20mg
Suspension (BCCH): 10 mg/mL
Intrathecal injection: 2000 mcg/mL
Suspension (BCCH): 10 mg/mL
Intrathecal injection: 2000 mcg/mL
Comments
May cause drowsiness, sedation, confusion, nausea, vomiting, constipation. A slower dose titration can minimize side effects.
May exacerbate seizures.
Worsens preexisting axial hypotonia at high doses.
Avoid abrupt withdrawal (hallucinations, seizures, worsening spasticity, confusion). Should be discontinued over at least 1-2 weeks or longer.
Maximum effect for muscle relaxation is not seen for 5-7 days.
References
44, 491, 492, 493, 494
Luc QN, Querubin J. Clinical Management of Dystonia in Childhood. Paediatr Drugs. 2017 Oct;19(5):447-461.
Goyal V, Laisram N, Wadhwa RK, Kothari SY. Prospective randomized study of oral diazepam and baclofen on spasticity in cerebral palsy. J Clin Diagn Res. 2016;10(6) :RC01-RC5.
Lubsch L, Habersang R, Haase M, Luedtke S. Oral baclofen and clonidine for treatment of spasticity in children. J Child Neurol. 2006;21(12):1090-1092.
Goyal V, Laisram N, Wadhwa RK, Kothari SY. Prospective randomized study of oral diazepam and baclofen on spasticity in cerebral palsy. J Clin Diagn Res. 2016;10(6) :RC01-RC5.
Lubsch L, Habersang R, Haase M, Luedtke S. Oral baclofen and clonidine for treatment of spasticity in children. J Child Neurol. 2006;21(12):1090-1092.
Scheinberg A, Hall K, Lam LT, O'Flaherty S. Oral baclofen in children with cerebral palsy: a double-blind cross-over pilot study. J Paediatr Child Health. 2006;42(11):715-20.
Last Edited
2021-11-08 06:47:22