Baclofen
ยาคลายกล้ามเนื้อ (muscle relaxants) ที่ได้รับการรับรองจาก USFDA สำหรับข้อบ่งใช้ spasticity เช่น baclofen, dantrolene และ tizanidine
1. ยากลุ่มนี้ใช้บรรเทาการหดเกร็งของกล้ามเนื้อที่เป็นรุนแรงในโรคบางชนิด เช่น บาดทะยัก การบาดเจ็บของไขสันหลัง และ multiple sclerosis
2. ไม่ใช้ยากลุ่มนี้กับอาการหดเกร็งกล้ามเนื้อจากการเล่นกีฬาหรือการบาดเจ็บ
3. ควรใช้ยากลุ่มนี้ด้วยความระมัดระวัง เนื่องจากการลด muscle tone อาจเพิ่ม disability ให้กับผู้ป่วย
▪️Name of the medicinal product
Baclofen Tablets 10 mg
▪️Therapeutic indications
The Food and Drug Administration (FDA) approved baclofen to treat muscle spasms related to multiple sclerosis or spinal cord problems. It helps to relieve flexor spasms, which occur when the leg and hip muscles become so tight that the limbs become locked in a bent position and difficult to straighten. baclofen can also help with the associated pain, clonus (involuntary, rhythmic muscle contractions), and muscular rigidity.
⛔You should not take baclofen:
To treat muscle spasms related to joint problems
If you have been diagnosed with cerebral palsy, Parkinson's disease, or a stroke
If you have had a previous allergic reaction to baclofen
⚠️Common Side Effects
Feeling tired
Nausea
Headache
Constipation
Weakness
❗Severe Side Effects
Fainting or passing out
Confusion
Seizures
Balance or posture changes
Depression
High blood pressure
Ovarian cysts
Increased seizures in people with epilepsy
❗It is important to continue taking baclofen until your healthcare provider tells you to stop. Suddenly stopping this medication can worsen your symptoms or cause the following side effects:
Increased muscle stiffness
Itching
Tingling in hands and feet
Seizures
Hallucinations
Confusion
High blood pressure
High fever
💊 Dosage
For muscle relaxation:
For oral dosage form (granules):
Adults and children 12 years of age and older—At first, 5 milligrams (mg) 3 times a day for 3 days. Your doctor may increase your dose by 5 mg every 3 days as needed and tolerated. However, the dose is usually not more than 80 milligrams (mg) per day (20 mg four times a day).
Children younger than 12 years of age—Use and dose must be determined by your doctor.
💊For oral dosage form (tablets):
Adults and teenagers—In patients with normal renal function, the standard dose of oral baclofen is 5 mg three times a day, which can slowly be titrated up by 15 mg a day every three to five days, to a maximum of 80 mg daily in divided doses.
Also some patients benefit from the use of baclofen only at night to counteract painful flexor spasm. Similarly a single dose given approximately 1 hour prior to the performance of specific tasks such as washing, dressing, shaving, physiotherapy, will often improve mobility.
Children—Use and dose must be determined by your doctor.
🤰Pregnancy
During pregnancy, especially in the first 3 months, baclofen should only be employed if its use is of vital necessity. The benefits of the treatment for the mother must be carefully weighed against the possible risks for the child. Baclofen crosses the placental barrier.
🧙♂️Elderly patients may be more susceptible to side-effects, particularly in the early stages of introducing baclofen. Small doses should therefore be used at the start of the treatment, the dose being titrated gradually against the response, under careful supervision. There is no evidence that the eventual average maximum dose differs from that in younger patients.
‼️You should not take more than 80 milligrams (the maximum dosage) per day.
a maximum daily dose of more than 100 mg is not advised unless the patient is in hospital under careful medical supervision.
‼️Patients with renal impairment:
In patients with impaired renal function or undergoing chronic haemodialysis, a particularly low dosage of baclofen should be selected i.e. approximately 5 mg daily.
Baclofen should be administered to end stage renal failure patients only if the expected benefit outweighs the potential risk. These patients should be closely monitored for prompt diagnosis of early signs and/or symptoms of toxicity (e.g. somnolence, lethargy)
Note : A commonly prescribed muscle relaxant known as baclofen can leave older kidney patients so disoriented that they land in the hospital, a new study warns.
"In our older patients with impaired kidney function, there should be cautious use of this medication."
⚠️Patients with hepatic impairment:
No studies have been performed in patients with hepatic impairment receiving baclofen therapy. The liver does not play a significant role in the metabolism of baclofen after oral administration of baclofen (see section 5.2). However, baclofen has the potential of elevating liver enzymes. Baclofen should be prescribed with caution in patients with hepatic impairment.
🛑Effects on ability to drive and use machines
Baclofen may be associated with adverse effects such as dizziness, sedation, somnolence and visual impairment which may impair the patient's reaction. Patients experiencing these adverse reactions should be advised to refrain from driving or operating machinery.
🛑Avoid drinking alcohol while taking baclofen as alcohol is a depressant that can cause worsening adverse effects.
🛑Avoid taking any baclofen product with central nervous system (CNS) depressant medications. Baclofen and CNS depressants both decrease the activity of the nervous system. Therefore, taking both at the same time can slow breathing and lead to unresponsiveness or severely low blood pressure.
Common CNS depressants include:
Benzodiazepines, such as Halcion (triazolam) and Restoril (temazepam)
Other types of prescribed sleeping medications, such as Ambien (zolpidem) and Belsomra (suvorexant)
Opioids, such as hydrocodone and fentanyl
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ภาพจาก
https://www.verywellhealth.com/lyvispah-baclofen-oral-5225158
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🤔การจัดการอาการไอจากยา Enalapril
What is there to know about baclofen and alcohol?
Baclofen is a muscle relaxant medication that binds to GABA receptors. GABA is an amino acid that inhibits the central nervous system (CNS). The FDA has approved it to treat muscle spasticity from multiple sclerosis, and it is also used in people with spinal cord conditions. sometimes used to treat alcohol use disorder (AUD).
The main advantage of baclofen is that it may be safe to use in people with liver disease, affecting some people with AUD. Despite this, the medication still has risks. High doses may cause dangerous side effects, such as seizures and coma.
Data analysis suggested that the medication may increase abstinent days and decrease heavy drinking. Males benefited more from the 90 mg per day dose, while females benefited more from the 30 mg per day dose.
At present, the FDA has not approved baclofen for AUD.
FDA-approved medications for AUD include:
disulfiram (Antabuse)
acamprosate (Campral)
oral naltrexone and extended-release naltrexone (Vivitrol)
Note
Study author Dr. Andy Jones, added, “This new meta-analysis shows that baclofen is no more effective than placebo on a range of key outcome measures, suggesting that the current increasing use of baclofen as a treatment for alcohol use disorders is premature.”
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ภาพจาก
https://www.fda.moph.go.th/sites/oss/Shared%20Documents/update%20PIL%203-4/Baclofen_PIL.pdf
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ภาพจาก
http://www.paphayomhospital.go.th/medicine/file/Baclofen.pdf
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POSTED 2023.01.20
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