Manufacturer: Various
Known as: Baclofen
| Package | Price | Per pill |
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| 10 pills | $46.53 | $4.65 |
| Package | Price | Per pill |
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| 10 pills | $41.71 | $4.17 |
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General Information of Baclofen
Baclofen is a centrally acting skeletal muscle relaxant that plays a critical role in the management of spasticity. Conditions such as multiple sclerosis, spinal cord injuries, cerebral palsy, and post-stroke syndromes often lead to debilitating stiffness and involuntary spasms. In these cases, baclofen provides meaningful relief and helps restore mobility and independence.
The medication is most often prescribed in the form of baclofen 10 mg or baclofen 20 mg oral tablets, although liquid and intrathecal preparations are also available.
Since baclofen acts directly on the central nervous system, it requires careful dosing and ongoing medical supervision. Abrupt changes in therapy can lead to serious complications, which is why physicians emphasize gradual titration and strict monitoring. Always consult your doctor before starting or changing baclofen dosage.
Composition and Active Ingredients
The active ingredient is baclofen itself, a derivative of gamma-aminobutyric acid (GABA). Tablets are usually supplied in 10 mg and 20 mg strengths, while an oral solution is available for patients who cannot swallow pills. In severe cases of spasticity that do not respond to oral treatment, baclofen may also be administered intrathecally via a surgically implanted pump. Excipients such as lactose, starch, or cellulose may vary depending on the manufacturer, but they do not affect the therapeutic action.
Pharmacological Action
How baclofen works is closely tied to its ability to mimic the neurotransmitter GABA at the GABA-B receptors in the spinal cord. When these receptors are activated, excitatory signals that normally increase muscle tone are dampened, which reduces spasticity. Unlike benzodiazepines, which act on GABA-A receptors and often cause sedation, baclofen’s selectivity allows it to relax muscles while maintaining a relatively favorable side-effect profile.
Patients typically begin to notice benefits within several days of initiation, although full effects may take weeks as the dose is gradually adjusted. The drug’s action is most pronounced in lowering muscle stiffness, improving mobility, and reducing painful spasms, thereby enhancing quality of life in patients with chronic neurological disease.
What is baclofen used for?
The FDA approval covers treatment of spasticity resulting from multiple sclerosis and spinal cord injury or disease. However, baclofen uses extend beyond these official indications. In clinical practice, it is commonly prescribed for patients recovering from stroke or living with cerebral palsy, where spasticity significantly impairs daily functioning. Pediatric use is generally off-label but may be considered in carefully monitored cases.
Researchers have also explored baclofen’s potential for conditions outside of neurology. It has been studied in alcohol dependence, where it may reduce cravings, and in difficult-to-treat cases of persistent hiccups. These applications remain off-label, but they demonstrate the drug’s broader potential.
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Price and Availability
Generic baclofen is widely available in the United States, making it relatively inexpensive compared to some newer antispasmodic medications. The standard tablet forms, baclofen 10 mg and baclofen 20 mg, are commonly stocked. Oral solutions are also accessible, though less frequently prescribed.
Ordering and Delivery
Like other prescription drugs, baclofen cannot be purchased over the counter in the U.S. Patients must first obtain a prescription, either through an in-person appointment or via telemedicine services. Once prescribed, baclofen can be ordered online through licensed pharmacies, with most offering home delivery and refill reminders.
Dosage and Administration
The correct baclofen dosage depends on the patient’s age, underlying condition, and response to treatment. Therapy typically begins with small doses that are gradually increased to balance effectiveness with tolerability.
| Patient Group | Initial Dosage | Titration | Maximum Recommended |
|---|---|---|---|
| Adults (oral) | 5 mg three times daily | Increase by 5 mg every 3 days | 80 mg/day (20 mg four times daily) |
| Children (≥12 years) | 5 mg two or three times daily | Adjust based on body weight and clinical response | 60 mg/day |
| Children (<12 years, off-label) | ~1–2 mg/kg/day in divided doses | Strict pediatric supervision | As directed by physician |
| Intrathecal therapy | 50 mcg test dose | Titrated by pump | Individualized |
A crucial safety point is that baclofen must never be stopped suddenly. Withdrawal can lead to hallucinations, seizures, hyperthermia, rebound spasticity, rhabdomyolysis, and even multi-organ failure. This risk is particularly high with intrathecal therapy, where pump malfunction or abrupt discontinuation can be life-threatening.
Can You Take Baclofen with Alcohol?
Alcohol should be avoided while on baclofen. Both substances depress the central nervous system, and their combination may lead to excessive drowsiness, impaired coordination, and even respiratory depression. This risk is especially dangerous for elderly patients or those taking other sedatives.
Available Forms
- Baclofen tablets (10 mg and 20 mg): the most common prescription form, used for gradual titration and long-term therapy.
- Oral solution: an alternative for patients who cannot swallow tablets or need more flexible dosing.
- Intrathecal baclofen (ITB): administered directly into the spinal fluid through an implanted pump, reserved for severe spasticity unresponsive to oral therapy. Abrupt discontinuation or pump malfunction can be life-threatening and requires immediate medical attention.
Side Effects and Contraindications
Common Baclofen Side Effects
The most common adverse effects are drowsiness, fatigue, dizziness, muscle weakness, nausea, constipation, and headache. These tend to occur during the early stages of therapy or after dosage increases. In many cases, the body adapts within days to weeks, and symptoms diminish over time or after lowering the dose.
Serious Side Effects
Although less frequent, serious complications include confusion, hallucinations, seizures, respiratory depression, and profound hypotension. Intrathecal administration carries added risks: sudden pump failure or catheter problems can precipitate severe withdrawal syndromes requiring urgent intervention.
Contraindications
Baclofen is contraindicated in patients with hypersensitivity to the drug. It should also be avoided in individuals with active peptic ulcer disease. Conditions such as epilepsy and psychiatric disorders do not preclude use but require extra monitoring, as baclofen may exacerbate symptoms in some patients.
Pregnancy and Breastfeeding
Use during pregnancy is only recommended if the potential benefits outweigh risks. Data from animal studies suggest possible teratogenicity, and clinical evidence remains limited. In breastfeeding, baclofen does pass into breast milk in small amounts. Therefore, physicians weigh maternal need against possible infant exposure before prescribing.
Baclofen Interactions
Because baclofen acts on the central nervous system, it interacts with many other drugs that have sedative properties.
- CNS depressants (opioids, benzodiazepines, alcohol, other muscle relaxants): These combinations increase the risk of sedation, respiratory depression, and falls.
- Antihypertensives: The blood pressure–lowering effect may be amplified, resulting in hypotension.
- Tricyclic antidepressants: Concurrent use may intensify muscle weakness.
- NSAIDs: There is no direct drug–drug interaction, but using NSAIDs alongside baclofen may place additional stress on the kidneys, requiring careful monitoring of renal function.
Patients should always provide a full list of medications and supplements to their healthcare provider before starting baclofen.
Special Populations
- Elderly patients: More sensitive to sedation, dizziness, and cognitive side effects. They face an increased risk of falls and confusion, so treatment should begin with lower doses and careful titration.
- Children: Use in children under 12 is generally off-label. When prescribed, baclofen must be dosed strictly by body weight and supervised by a pediatric neurologist or rehabilitation specialist.
- Kidney disease: Baclofen is primarily excreted through the kidneys. In patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD), the drug may accumulate and cause neurotoxicity. Dose reduction is essential, and in severe cases baclofen should be avoided.