Baclofen Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Muscle Spasm

Oral: Initial dose: 5 mg orally 3 times a day for 3 days, then 10 mg orally 3 times a day for 3 days, then 15 mg orally 3 times a day for 3 days, then 20 mg orally 3 times a day.
Maintenance dose: 40-80 mg/day.
80 mg/day doses should be administered in 4 divided doses.

Intrathecal: Test dose: 50 mcg (in a volume of 1 mL) injected into the intrathecal space by barbotage over at least 1 minute. Observe patient for 4-8 hours for a positive response.
Second test dose: If no positive response to first test dose, 75 mcg (in a volume of 1.5 mL) may be administered 24 hours later.
Third test dose: If no positive response to second test dose, 100 mcg (in a volume of 2 mL) may be administered 24 hours later. If no positive response to third test dose, the patient should not be considered for chronic intrathecal therapy.
The test dose that received a positive response should be doubled and given over 24 hours. If the test dose maintained a positive response for > 12 hours, the starting daily dose should be the same as the effective test dose. After 24 hours, the dose may be titrated by 10%-20% increments every day until the desired clinical effect is achieved. Over time, many patients will require gradual dose increases to maintain the desired clinical effect. Patients have been maintained on daily doses of 12-1500 mcg. Most patients require 300-800 mcg/day.

Usual Adult Dose for Trigeminal Neuralgia

Oral: Initial dose: 5 mg orally 3 times a day for 3 days, then 10 mg orally 3 times a day for 3 days, then 15 mg orally 3 times a day for 3 days, then 20 mg orally 3 times a day.
Maintenance dose: 40-80 mg/day.
80 mg/day doses should be administered in 4 divided doses.

Intrathecal: Test dose: 50 mcg (in a volume of 1 mL) injected into the intrathecal space by barbotage over at least 1 minute. Observe patient for 4-8 hours for a positive response.
Second test dose: If no positive response to first test dose, 75 mcg (in a volume of 1.5 mL) may be administered 24 hours later.
Third test dose: If no positive response to second test dose, 100 mcg (in a volume of 2 mL) may be administered 24 hours later. If no positive response to third test dose, the patient should not be considered for chronic intrathecal therapy.
The test dose that received a positive response should be doubled and given over 24 hours. If the test dose maintained a positive response for > 12 hours, the starting daily dose should be the same as the effective test dose. After 24 hours, the dose may be titrated by 10%-20% increments every day until the desired clinical effect is achieved. Over time, many patients will require gradual dose increases to maintain the desired clinical effect. Patients have been maintained on daily doses of 12-1500 mcg. Most patients require 300-800 mcg/day.

Usual Adult Dose for Hiccups

Initial dose: 5 mg orally 3 times a day for 3 days, then 10 mg orally 3 times a day for 3 days, then 15 mg orally 3 times a day for 3 days, then 20 mg orally 3 times a day.
Maintenance dose: 40-80 mg/day.
80 mg/day doses should be administered in 4 divided doses.

Usual Adult Dose for Cerebral Spasticity

Intrathecal: Test dose: 50 mcg (in a volume of 1 mL) injected into the intrathecal space by barbotage over at least 1 minute. Observe patient for 4-8 hours for a positive response.
Second test dose: If no positive response to first test dose, 75 mcg (in a volume of 1.5 mL) may be administered 24 hours later.
Third test dose: If no positive response to second test dose, 100 mcg (in a volume of 2 mL) may be administered 24 hours later. If no positive response to third test dose, the patient should not be considered for chronic intrathecal therapy.
If a positive response has occurred following a test dose, an intrathecal infusion device may be surgically implanted.
The test dose that received a positive response should be doubled and given over 24 hours. If the test dose maintained a positive response for > 12 hours, the starting daily dose should be the same as the effective test dose. After 24 hours, the dose may be titrated by 10%-20% increments every day until the desired clinical effect is achieved. Over time, many patients will require gradual dose increases to maintain the desired clinical effect. Patients have been maintained on daily doses of 12-1500 mcg. Most patients require 300-800 mcg/day.

Renal Dose Adjustments

Baclofen dosage may need to be reduced and given with caution in patients with renal dysfunction.

Liver Dose Adjustments

Data not available

Dose Adjustments

The rate of titration and maximal doses used should generally be decreased in elderly patients or patients with psychiatric disease.

Precautions

Baclofen therapy should not be discontinued abruptly. Gradual dosage reductions of 10 mg/day every 2-3 days are recommended to avoid withdrawal symptoms.

Extreme caution must be used when filling an FDA approved implantable pump. Such pumps should only be refilled through the reservoir refill septum. Inadvertent injection into the subcutaneous tissue can occur if the reservoir refill septum is not properly accessed. Some pumps are also equipped with a catheter access port that allows direct access to the intrathecal catheter. Direct injection into this catheter access port or inadvertent injection into the subcutaneous tissue may cause a life-threatening overdose.

Dialysis

Data not available

Other Comments

Patients should only be considered for intrathecal treatment following an adequate trial of oral baclofen.

Oral baclofen should be administered with food or milk.

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