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Apo-Baclofen (CA), Baclofen, Gen-Baclofen (CA), Kemstro, Lioresal, Lioresal Intrathecal, Liotec (CA), Lyflex (UK), Nu-Baclo (CA), PMS-Baclofen (CA)

Pharmacologic class: Skeletal muscle relaxant

Therapeutic class: Antispasmodic

Pregnancy risk category C

FDA Box Warning

• With intrathecal form, abrupt withdrawal may cause high fever, altered mental status, exaggerated rebound spasticity, and muscle rigidity; in rare cases, patient progresses to rhabdomyolysis, multisystem failure, and death. To prevent abrupt withdrawal, pay careful attention to programming and monitoring of infusion system, refill scheduling and procedures, and pump alarms. Advise patients and caregivers of importance of keeping scheduled refill visits, and teach about early drug withdrawal symptoms. Give special attention to patients at apparent risk (those with spinal cord injuries at T6 or above, communication problems, or history of withdrawal symptoms from oral or intrathecal baclofen).


Relaxes muscles by acting specifically at spinal end of upper motor neurons


Intrathecal injection: 10 mg/20 ml (500 mcg/ml), 10 mg/5 ml (2,000 mcg/ml)

Tablets: 10 mg, 20 mg

Indications and dosages

Reversible spasticity associated with multiple sclerosis or spinal cord lesions

Adults: Initially, 5 mg P.O. t.i.d. May increase by 5 mg q 3 days to a maximum dosage of 80 mg/day.

Children ages 4 and older: 25 to 1,200 mcg/day by intrathecal infusion; (average is 275 mcg/day); dosage determined by response during screening phase.

Severe spasticity in patients who don't respond to or can't tolerate oral baclofen

Adults: Screening phase-Before pump implantation and intrathecal infusion, give test dose to check responsiveness. Administer 1 ml of 50 mcg/ml dilution over 1 minute by barbotage into intrathecal space. Within 4 to 8 hours, muscle spasms should become less severe or frequent and muscle tone should decrease; if patient's response is inadequate, give second test dose of 75 mcg/1.5 ml 24 hours after first dose. If patient is still unresponsive, may give final test dose of 100 mcg/2 ml 24 hours later. Patients unresponsive to 100-mcg dose aren't candidates for intrathecal baclofen. Following appropriate responsiveness, adjust dosage to twice the screening dose and give over 24 hours. If screening dose efficacy is maintained for 12 hours, don't double the dosage. After 24 hours, increase dosage slowly as needed and tolerated by 10% to 30% daily.

Maintenance therapy-During prolonged maintenance therapy, adjust daily dosage by 10% to 40% as needed and tolerated to maintain adequate control of symptoms. Maintenance dosage ranges from 12 mcg to 2,000 mcg daily.

Dosage adjustment

• Renal impairment

• Seizure disorders

• Elderly patients

Off-label uses

• Cerebral palsy

• Tardive dyskinesia

• Trigeminal neuralgia


• Hypersensitivity to drug

• Rheumatic disorders


Use cautiously in:

• renal impairment

• epilepsy

• patients who use spasticity to maintain posture and balance

• elderly patients

• pregnant or breastfeeding patients

• children.


• Give oral doses with food or milk.

• Dilute only with sterile, preservative-free sodium chloride for injection.

• Know that intrathecal infusion should be performed only by personnel who have been trained in the procedure.

Adverse reactions

CNS: dizziness, drowsiness, fatigue, confusion, depression, headache, insomnia, hypotonia, difficulty speaking, seizures

CV: edema, hypotension, hypertension, palpitations

EENT: blurred vision, tinnitus, nasal congestion

GI: nausea, vomiting, constipation

GU: urinary frequency, dysuria, erectile dysfunction

Metabolic: hyperglycemia

Skin: pruritus, rash, sweating

Other: weight gain, hypersensitivity reactions


Drug-drug. CNS depressants: increased baclofen effect

MAO inhibitors: increased CNS depression, hypotension

Tricyclic antidepressants, drugs causing

CNS depression: hypotonia, increased

CNS depression

Drug-diagnostic tests. Alkaline phosphatase, aspartate aminotransferase, glucose: increased levels

Drug-behaviors. Alcohol use: CNS depression

Patient monitoring

• During intrathecal infusion, check pump often for proper functioning and check catheter for patency.

• Monitor patient's response continually to determine appropriate dosage adjustment.

Observe closely for signs and symptoms of overdose (drowsiness, light-headedness, dizziness, respiratory depression), especially during initial screening and titration. No specific antidote exists. Immediately remove any solution from pump; if patient has respiratory depression, intubate until drug is eliminated.

Patient teaching

• Advise patient to take oral dose with food or milk.

• Instruct patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Caution patient not to discontinue drug therapy abruptly. Doing so may cause hallucinations and rebound spasticity.

• Advise patient to avoid alcohol and other depressants such as sedatives while taking drug.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.


a trademark for an antispastic agent (baclofen).


A GABA (gamma-aminobutyric acid) antagonist used to decrease recalcitrant spinal spasticity in patients with multiple sclerosis, spinal-cord injury and possibly also Parkinson’s disease.
Adverse effects
Vomiting, weakness, drowsiness, slow breathing, seizures, coma.


A brand name for BACLOFEN.
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Tizanidine [brand name Zanaflex] has recently been approved by the FDA and is similar to lioresal, which has been on the market for some time.
The drug Lioresal has given Nolan a minimal degree of muscular control in his neck so that he can hit the keys on a typewriter by means of a stick affixed to his head.
Oral medications, for spasticity includes Tizanidine( Maximum 36 mg), Lioresal ( Max 100-120mg, Benzodiazepines (Diazepam, clonazepam), Others are (Eperisone, Cyclobenzaprine) Injections Local anesthetics, Ethanol and Phenol Blocks and Botulinum Toxin, Ethanol and phenol denaturation of proteins, eithertemporally or permanently.
Lioresal Intrathecal (baclofeno injection) [citado Abr 2002].
Milford, charged with possession of Adderall, possession of Lioresal Soma, possession of cocaine, possession of Klonopin, failing to use care when stopping, driving with a suspended license, and refusing to identify himself to police, continued to Jan.
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The company also received FDA approval to market baclofen tablets, the generic equivalent of Geigy Pharmaceuticals' Lioresal, and metaproterenol sulfate syrup, the generic form of Boehringer Ingelheim Inc.
Acamprosate * Campral Baclofen * Lioresal Disulfiram Antabuse Gabapentin Neurontin Metronidazole * Flagyl
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Adductor spasms can be curbed by taking Lioresal (baclofen), antispastic drug.