Baclofen

Baclofen Brand Names

BACLOFEN | ED Baclofen | EnovaRX | Equipto Baclofen | First-Baclofen | Gablofen | Lioresal | OZOBAX

What is Baclofen

Baclofen is an oral skeletal muscle relaxant. It is a structural analog of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA).

Clinically, baclofen is used to treat spasticity and improve mobility in patients with multiple sclerosis and other spinal cord lesions by decreasing the number and severity of spasms and relieving associated pain, clonus, and muscle rigidity. Baclofen also improves bowel and bladder function in some of these patients.

Baclofen (Lioresal®) was approved by the FDA in November 1977.

In February 1995, the FDA granted approval under a treatment IND to use intrathecal baclofen (Lioresal® Intrathecal) for the treatment of spasticity of cerebral origin; full FDA approval was granted in 1997.

An orally-disentegrating tablet formulation (Kemstro™) was FDA-approved in late 2003; however, the product was never commercially launched in the U.S. by the manufacturer.

Indications

1. gastroesophageal reflux disease (GERD)
2. multiple sclerosis
3. muscle spasm
4. nystagmus
5. singultus (hiccups)
6. spasticity
7. spinal cord injury
8. stuttering priapism
9. trigeminal neuralgia

For the treatment of spasticity, muscle spasm (not due to rheumatic conditions), myoclonus, and muscle rigidity in multiple sclerosis and spinal cord injury or diseases

Side Effects

1. abdominal pain
2. agitation
3. akathisia
4. alopecia
5. amnesia
6. anemia
7. anorexia
8. anxiety
9. apnea
10. asthenia
11. ataxia
12. back pain
13. blurred vision
14. bradycardia
15. bronchospasm
16. chest pain (unspecified)
17. chills
18. coma
19. confusion
20. constipation
21. depression
22. diarrhea
23. diplopia
24. disseminated intravascular coagulation (DIC)
25. dizziness
26. drowsiness
27. dysarthria
28. dysgeusia
29. dyskinesia
30. dyspepsia
31. dyspnea
32. dystonic reaction
33. dysuria
34. ejaculation dysfunction
35. emotional lability
36. encephalopathy
37. euphoria
38. flatulence
39. hallucinations
40. headache
41. hematuria
42. hyperglycemia
43. hyperhidrosis
44. hypersalivation
45. hypertension
46. hypertonia
47. hyperventilation
48. hyporeflexia
49. hypotension
50. hypothermia
51. hypotonia
52. hypoventilation
53. ileus
54. impaired cognition
55. impotence (erectile dysfunction)
56. increased urinary frequency
57. influenza
58. insomnia
59. leukocytosis
60. libido decrease
61. malaise
62. malignant hyperthermia
63. meningitis
64. miosis
65. musculoskeletal pain
66. mydriasis
67. nasal congestion
68. nausea
69. neuroleptic malignant syndrome
70. nocturia
71. nystagmus
72. oliguria
73. orgasm dysfunction
74. orthostatic hypotension
75. palpitations
76. paranoia
77. paresthesias
78. peripheral edema
79. petechiae
80. premature atrial contractions (PACs)
81. priapism
82. pruritus
83. psychological dependence
84. psychosis
85. pulmonary embolism
86. QT prolongation
87. rash
88. renal failure (unspecified)
89. respiratory depression
90. rhabdomyolysis
91. rhinitis
92. seizures
93. skin ulcer
94. stroke
95. suicidal ideation
96. thrombosis
97. tinnitus
98. tremor
99. urinary incontinence
100. urinary retention
101. urticaria
102. vaginitis
103. ventricular tachycardia
104. vomiting
105. weakness
106. weight gain
107. withdrawal
108. xerostomia

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• abrupt discontinuation
• anticoagulant therapy
• bipolar disorder
• breast-feeding
• cerebral palsy
• children
• coadministration with other CNS depressants
• coagulopathy
• dental disease
• depression
• diabetes mellitus
• dialysis
• driving or operating machinery
• epidural administration
• ethanol ingestion
• geriatric
• head trauma
• infants
• infection
• intracranial bleeding
• intramuscular administration
• intrathecal administration
• intravenous administration
• ovarian cyst
• phenylketonuria
• pregnancy
• priapism
• psychosis
• renal failure
• renal impairment
• schizophrenia
• seizure disorder
• seizures
• stroke
• subcutaneous administration
• thrombocytopenia

Interactions

• Acebutolol
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Codeine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Tramadol
• Alfentanil
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Alprazolam
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxapine
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Anxiolytics; Sedatives; and Hypnotics
• Apomorphine
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atenolol
• Atenolol; Chlorthalidone
• Atracurium
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine
• Azelastine; Fluticasone
• Bacitracin
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzodiazepines
• Beta-adrenergic blockers
• Betaxolol
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Botulinum Toxins
• Brimonidine; Timolol
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Buprenorphine
• Buprenorphine; Naloxone
• Buspirone
• Butabarbital
• Butorphanol
• Calcium-channel blockers
• Cannabidiol
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carbetapentane; Chlorpheniramine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbetapentane; Pyrilamine
• Carbidopa; Levodopa; Entacapone
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carteolol
• Carvedilol
• Cenobamate
• Central-acting adrenergic agents
• Cetirizine
• Cetirizine; Pseudoephedrine
• Chloral Hydrate
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpromazine
• Cisatracurium
• Clevidipine
• Clonazepam
• Clorazepate
• Clozapine
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• COMT inhibitors
• Deutetrabenazine
• Dexmedetomidine
• Dextromethorphan; Promethazine
• Diazepam
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diltiazem
• Diphenhydramine; Hydrocodone; Phenylephrine
• Dorzolamide; Timolol
• Doxacurium
• Doxazosin
• Dronabinol
• Droperidol
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Enflurane
• Entacapone
• Eplerenone
• Epoprostenol
• Esketamine
• Esmolol
• Estazolam
• Eszopiclone
• Ethanol
• Etomidate
• Felodipine
• Fentanyl
• Fluphenazine
• Flurazepam
• Fosinopril
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fospropofol
• Gabapentin
• General anesthetics
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Halothane
• Homatropine; Hydrocodone
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Ibuprofen; Oxycodone
• Iloprost
• Isoflurane
• Isradipine
• Ketamine
• Labetalol
• Lasmiditan
• Levobetaxolol
• Levobunolol
• Levocetirizine
• Levorphanol
• Lisinopril
• Lofexidine
• Loop diuretics
• Lorazepam
• Loxapine
• Lumateperone
• Maprotiline
• Mecamylamine
• Mepenzolate
• Meperidine
• Meperidine; Promethazine
• Mephobarbital
• Meprobamate
• Mesoridazine
• Methadone
• Methocarbamol
• Methohexital
• Methscopolamine
• Metoprolol
• Midazolam
• Mirtazapine
• Mivacurium
• Moexipril
• Molindone
• Morphine
• Morphine; Naltrexone
• Nabilone
• Nadolol
• Nalbuphine
• Nebivolol
• Nebivolol; Valsartan
• Neuromuscular blockers
• Nicardipine
• Nifedipine
• Nimodipine
• Nisoldipine
• Oxazepam
• Oxycodone
• Oxymorphone
• Pancuronium
• Penbutolol
• Pentazocine
• Pentazocine; Naloxone
• Pentobarbital
• Perindopril
• Perindopril; Amlodipine
• Perphenazine
• Perphenazine; Amitriptyline
• Phenobarbital
• Phenothiazines
• Phenoxybenzamine
• Phentolamine
• Phenylephrine; Promethazine
• Pindolol
• Potassium-sparing diuretics
• Prazosin
• Pregabalin
• Primidone
• Prochlorperazine
• Promethazine
• Propofol
• Propranolol
• Quazepam
• Quinapril
• Ramipril
• Rapacuronium
• Remifentanil
• Reserpine
• Rocuronium
• Secobarbital
• Sedating H1-blockers
• Sevoflurane
• Sodium Oxybate
• Spironolactone
• Succinylcholine
• Sufentanil
• Tapentadol
• Temazepam
• Terazosin
• Thalidomide
• Thiazide diuretics
• Thiethylperazine
• Thiopental
• Thioridazine
• Thiothixene
• Timolol
• Tizanidine
• Tolcapone
• Tramadol
• Trandolapril
• Trandolapril; Verapamil
• Trazodone
• Treprostinil
• Triamterene
• Triazolam
• Tricyclic antidepressants
• Trifluoperazine
• Tubocurarine
• Valerian, Valeriana officinalis
• Vasodilators
• Vecuronium
• Verapamil
• Zaleplon
• Ziprasidone
• Zolpidem