Medically reviewed by Drugs.com. Last updated on Feb 27, 2023.
Applies to the following strengths: 4 mg; 2 mg; 6 mg
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Muscle Spasm
Initial dose: 2 mg orally every 6 to 8 hours as needed
- Peak effects occur in approximately 1 to 2 hours and last for 3 to 6 hours; treatment can be repeated as needed to a maximum of 3 doses in 24 hours; gradually increase dose by 2 to 4 mg at intervals of 1 to 4 days until satisfactory reduction of muscle tone is achieved.
Maximum daily dose: 36 mg in 24 hours
- Clinically significant differences in absorption are expected between capsules and tablets when taken with or without food; these differences could result in changes in efficacy and tolerability.
- Once a formulation is decided on and a decision is made to take with or without food, this regimen should not be altered.
Use: Management of spasticity.
Renal Dose Adjustments
Severe renal impairment (CrCl less than 25 mL/min): Individualize therapy with lower doses during dose titration; if higher doses are required, individual doses should be increased rather increasing the dosing frequency; closely monitor for toxicity
Liver Dose Adjustments
Use with caution in elderly patients, especially those with renal impairment.
- Decrease by 2 to 4 mg per day, especially in patients who have been receiving doses of 20 to 36 mg per day for periods of 9 weeks or more.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Data not available
- May take orally with or without food; however, once a formulation is decided on and a decision is made to take with or without food, this regimen should not be altered.
- Because this drug has a relatively short duration of effect, dosing should occur at times when relief of spasticity is most important, such as before activities of daily living.
- Considerable variation in response has been observed and therefore careful titration is necessary in order to not exceed the dose producing the desired effect.
- Gradual dose reduction is advised on discontinuation so as to minimize risk of withdrawal and rebound hypertension, tachycardia, and hypertonia.
- Obtain aminotransferase levels at baseline, 1 month after maximum dose is achieved, and as clinically indicated (e.g. if hepatic injury is suspected).
- Consider obtaining baseline renal function in elderly patients.
- Monitor for hypotension in at-risk patients and those receiving concomitant antihypertensive therapy.
- Monitor for sedation in patients receiving concomitant CNS depressant agents.
- Patients may take this drug with or without food, but once the decision is made to take with or without food it should be taken this way consistently.
- Patients should check with their healthcare provider before starting or stopping any medications as this drug is known to interact with other medications.
- Patients should be advised not to abruptly stop taking this medication without first talking with their healthcare provider.
- Patients should be advised that this drug may cause hypotension and they should be careful when changing positions form lying to standing.
- Patients should be advised this drug may cause significant somnolence, especially if taken with other CNS depressants or alcohol; they should refrain from activities requiring mental alertness until the effects of the drug are known.
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