Neurologic Drugs : Skeletal Muscle Relaxants
OBEFO1 “Befon tablet” 5 mg/tab
ILIOR2 “Lioresal injection 10 mg; 5 ml/amp
適應症：脊椎或腦部受傷引起之嚴重慢性痙攣。
Usual dose:
Adult:
PO：(> 12 yrs) 5 mg tid, increase 15 mg daily q3d; max. 80 mg/day in 3-4 divided doses.
Intrathecal route：
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Adults |
Children≥4 years and Adolescents |
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1. Screening dose |
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Intrathecal (IT) bolus ≧ 1 min, then increased by 25 mcg increments every 24 hrs until a positive response of 4-8 hr duration is demonstrated. |
Initially, 25-50 mcg, max, 100 mcg/dose. |
Initially, 25-50mcg, max, 100 mcg/dose |
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*Patients who fail to respond to 100mcg bolus should not receive implanted pump for chronic infusion |
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2. Post-Implant Dose Titration Period |
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First 24 hrs |
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Screening dose efficacy < 8 hr |
Double the screening dose IT over 24 hrs |
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Screening dose efficacy > 8 hr |
Maintain the screening dose IT over 24 hrs |
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Adjust dose |
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Spinal cord spasticity |
Increased by 10-30% q24h |
Increased by 5-15% q24h |
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Cerebral origin spasticity |
Increased by 5-15% q24h |
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3. Maintenance therapy |
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Increasing dose |
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Spinal cord spasticity |
Increased by 10-40% q24h |
Increased by 5-20% q24h |
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Cerebral origin spasticity |
Increased by 5-20% q24h |
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Decreasing dose (if patients experience side effects) |
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Spinal cord spasticity |
Decreased by 10-20% q24h |
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Cerebral origin spasticity |
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Contraindication:
Hypersensitivity to baclofen
Solution for intrathecal use only; IV, epidural, subQ, or IM administration not recommended.
Precaution:
Slow taper recommended, abrupt discontinuation should be avoided, except with serious adverse reactions or overdose related.
Adverse effect:
Common: constipation, nausea, vomiting, poor muscle tone,asthenia, dizziness, headache, somnolence.
Serious: aseptic meningitis, with intrathecal administration,coma, seizure, abrupt withdrawal.