Select a medication above to begin.
baclofen intrathecal
generic
Black Box Warnings .
Avoid Abrupt Cessation
high fever, altered mental status, exaggerated rebound spasticity, and muscle rigidity (rare cases advanced to rhabdomyolysis, multiple organ-system failure, and death) after abrupt D/C; prevent by proper infusion system programming/monitoring, refill scheduling/procedures, and pump alarms; teach pts/caregivers early baclofen withdrawal sx; give special attention to high risk pts (T-6 or above spinal cord injuries, communication difficulties, and baclofen withdrawal sx hx); refer to implantable infusion system manual for additional post-implant information
Adult Dosing .
Dosage forms: INJ
cerebral spasticity, severe
- [screening phase]
- Dose: 50 mcg intrathecally x1; Info: may give 75 mcg intrathecally x1 after 24h if inadequate response, then 100 mcg intrathecally x1 after another 24h; observe pt x4-8h after each dose to assess response; do not cont. tx if no response to 100 mcg test dose
- [initial dose titration]
- Dose: individualize dose intrathecally via implantable pump; Start: 2x effective screening dose/day intrathecally or if screening dose response >8h, give 1x effective screening dose/day intrathecally; may incr. dose 5-15% q24h
- [maintenance tx]
- Dose: 90-700 mcg/day intrathecally via implantable pump; Info: titrate to effect by incr. dose 5-20% or decr. dose 10-20% during pump refills; taper dose gradually to D/C
spinal cord spasticity, severe
- [screening phase]
- Dose: 50 mcg intrathecally x1; Info: may give 75 mcg intrathecally x1 after 24h if inadequate response, then 100 mcg intrathecally x1 after another 24h; observe pt x4-8h after each dose to assess response; do not cont. tx if no response to 100 mcg test dose
- [initial dose titration]
- Dose: individualize dose intrathecally via implantable pump; Start: 2x effective screening dose/day intrathecally or if screening dose response >8h, give 1x effective screening dose/day intrathecally; may incr. dose 10-30% q24h
- [maintenance tx]
- Dose: 300-800 mcg/day intrathecally via implantable pump; Info: titrate to effect by incr. dose 10-40% or decr. dose 10-20% during pump refills; taper dose gradually to D/C
renal dosing
- [see below]
- renal impairment: consider decr. usual dose
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ
cerebral or spinal cord spasticity, severe
- [screening phase, 4 yo and older]
- Dose: 50 mcg intrathecally x1; Info: may start 25 mcg intrathecally x1 in very small pts; may give 75 mcg intrathecally x1 after 24h if inadequate response, then 100 mcg intrathecally x1 after another 24h; observe pt x4-8h after each dose to assess response; do not cont. tx if no response to 100 mcg test dose
- [initial dose titration, 4 yo and older]
- Dose: individualize dose intrathecally via implantable pump; Start: 2x effective screening dose/day intrathecally or if screening dose response >8h, give 1x effective screening dose/day intrathecally; may incr. dose 5-15% q24h
- [maintenance tx, 4 yo and older]
- Dose: 90-700 mcg/day intrathecally via implantable pump; Info: pts <12 yo may require lower doses; titrate to effect by incr. dose 5-20% or decr. dose 10-20% during pump refills; taper dose gradually to D/C
renal dosing
- [see below]
- renal impairment: consider decr. usual dose
- HD/PD: not defined
hepatic dosing
- [not defined]