Therefore, except for serious adverse reactions, the dose should be reduced slowly when the drug is discontinued.īecause baclofen is primarily excreted unchanged through the kidneys, it should be given with caution, and it may be necessary to reduce the dosage.īaclofen has not significantly benefited patients with stroke. Hallucinations and seizures have occurred on abrupt withdrawal of baclofen. If slow withdrawal is not feasible, advise the parents or caregivers of the potential for neonatal withdrawal. If the potential benefit justifies the potential risk to the fetus and oral baclofen is continued during pregnancy, gradually reduce the dose and discontinue baclofen before delivery. The symptoms of withdrawal in these infants have included increased muscle tone, tremor, jitteriness, and seizure. Neonatal Withdrawal Symptoms: Withdrawal symptoms have been reported starting hours to days after delivery in neonates whose mothers were treated with oral baclofen throughout pregnancy. Baclofen is excreted primarily by the kidney in unchanged form and there is relatively large intersubject variation in absorption and/or elimination.Ī. Absorption may be dose-dependent, being reduced with increasing doses. Baclofen is rapidly and extensively absorbed and eliminated. In studies with animals baclofen has been shown to have general CNS depressant properties as indicated by the production of sedation with tolerance, somnolence, ataxia, and respiratory and cardiovascular depression. Although baclofen is an analog of the putative inhibitory neurotransmitter gamma-aminobutyric acid (GABA), there is no conclusive evidence that actions on GABA systems are involved in the production of its clinical effects. Baclofen is capable of inhibiting both monosynaptic and polysynaptic reflexes at the spinal level, possibly by hyperpolarization of afferent terminals, although actions at supraspinal sites may also occur and contribute to its clinical effect. The precise mechanism of action of baclofen is not fully known.
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