Overview of Baclofen
Baclofen was originally developed as an antiepileptic in 1962 and introduced in 1971 for the treatment of spasticity related to conditions such as multiple sclerosis․ It was ultimately approved by the US FDA in 1977․
History and Approval
Baclofen was originally developed as an antiepileptic in 1962 by Swiss chemist Heinrich Keberle․ Although it failed to effectively treat epilepsy, baclofen was found to reduce spasticity in selected patients․ It was introduced in 1971 and ultimately approved by the US Food and Drug Administration (FDA) in 1977 for the treatment of spasticity related to conditions like multiple sclerosis and spinal cord injuries․
Dosage Recommendations
Baclofen is recommended to be taken in doses ranging from 15 to 80 mg daily․ The initial dose for adults and children above 12 years old is typically 5 mg three times a day, which can be adjusted as needed․
Initial Dosage for Adults and Children
For adults and children aged 12 and above, the usual starting dose of oral baclofen is 5 milligrams three times a day for the initial three days․ The dose can then be gradually increased by 5 milligrams every three days until the desired response is achieved․
Maintenance Dosage for Long-Term Use
For long-term continuous infusion, a maintenance dosage of Baclofen ranges from 22 to 1400 mcg daily, with most patients effectively managed on 90 to 703 mcg daily․ It is crucial to tailor the dose to individual needs and adjust as necessary within the recommended range․
Administration Guidelines
Baclofen can be administered orally or intrathecally․ The optimal dosage should be individually determined and titrated gradually to achieve the desired effect, typically ranging between 40 to 80 mg daily․
Oral Administration
Oral administration of baclofen typically starts at 5 milligrams three times a day for adults and children aged 12 and above․ The dosage may be gradually increased by 5 milligrams every three days until the desired response is reached, with the total daily dose not exceeding 80 milligrams․
Intrathecal Administration
Intrathecal administration involves initiating with a single dose, typically 50 mcg of baclofen٫ observing the patient for 4 to 8 hours to assess efficacy․ The dose is then increased gradually every three days until the optimal response is achieved٫ with the total daily dose not exceeding 80 mg․
Titration Schedule
The recommended dosage titration schedule for Baclofen includes starting with 5 mg three times daily for 3 days, followed by increments of 10 mg and 15 mg also for 3 days each to achieve optimal effect․
Recommended Dosage Titration Steps
When titrating Baclofen dosage, typically start with 5 mg three times daily for 3 days٫ followed by increments of 10 mg and 15 mg for the subsequent 3-day periods until optimal effect is achieved․
Special Considerations
It is crucial to tailor the dosage of Baclofen to individual needs, gradually titrating between 40 to 80 mg daily to achieve the desired effect․ Dosage titration usually involves increasing the dose over several days to find the optimal level․
Pediatric Dosage Guidelines
For pediatric patients aged 4 to under 12 years, the daily dosage of baclofen may range from 24 to 1199 mcg/day, with a typical dosage of 274 mcg/day․ For children aged 12 years and older, the recommended dosage varies from 22 to 1400 mcg/day, with most patients effectively maintained on 90 to 703 mcg/day․
Withdrawal and Overdose Management
Management of acute intrathecal baclofen withdrawal involves proactive treatment options to address symptoms such as hyperactive states, spasticity exacerbation, and autonomic dysfunction, which could include hyperthermia and convulsions․
Treatment Options for Intrathecal Baclofen Withdrawal
Intrathecal baclofen withdrawal should be managed promptly with various treatment options to address symptoms like hyperactive states, spasticity exacerbation, and autonomic dysfunction, which can include hyperthermia and convulsions․ Consultation with healthcare providers for appropriate interventions is essential․
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