Oral baclofen is useful for symptomatic problems such as flexor and extensor spasms, stiffness and pain in patients with spinal cord injury and demyelinating myelopathies.
In patients with severe spasticity, it can be used in conjunction with diazepam. The efficacy of baclofen in patients with cerebrovascular accidents and cerebral palsy has not been established.
Oral baclofen is available as a refrigerated suspension of 5 mg/mL or as 10- and 20-mg tablets. When refrigerated, the suspension is stable for up to 35 days. Treatment in children is initiated with 2.5 to 5 mg qhs and titrated at weekly intervals to tid or qid dosages. In older patients, initiate therapy with 5 mg bid. Maximum doses for children are shown on the slide. In adults, the maximum dose ranges from 80 to 200 mg/d.
References:
Baclofen Package Insert, 2000.
Lataste X, Emre M, Davis C, et al. Comparative profile of tizanidine in the management of spasticity. Neurology 1994;44(suppl 9):S53-9.
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