The factors that most affect baclofen dosage are the way the drug is administered and the individual’s response to the medication. A patient’s medical condition also influences the amount that is needed, and any kidney damage may lower the dose or contraindicate the drug, entirely. Dosage is also governed by the philosophy that the lowest effective amount of the medication is given to avoid more significant side effects. Moreover, drug amounts almost always start small, and the medicine must be discontinued slowly.
Baclofen treats painful spasms that occur in multiple sclerosis or are associated with paralysis. It may also be prescribed to treat chronic hiccups or to aid in the initial recovery of alcohol addiction. The highest baclofen dosage is often employed for alcohol recovery, whereas lower doses tend to be used for the other conditions mentioned.
There are two ways that baclofen can be administered. It can be taken in a pill form, which melts in the mouth and doesn’t require water to swallow. Alternately, it can be given intrathecally. This delivery method is an injection of the drug into a permanent catheter that feeds into the spine.
Intrathecal baclofen dosage is in much lower amounts than oral doses. Initial injections may contain 50 micrograms (mcg), 75 mcg or 150 mcg, but if a patient responds well to 50 mcg then he might continue to receive this amount three times per day. Some people are assisted with an even lower dose, but typical amounts used are between 300-800 mcg daily. The intrathecal delivery method is generally only employed for people with multiple sclerosis or paralysis.
Oral baclofen doses are much larger. In the first few days 15 milligrams (mg) per day are given, and this amount may increase as needed up to 80 mg. Some patients respond positively on relatively low doses. As mentioned, for alcohol addiction, the higher 80 mg amount is sometimes required.
Since baclofen is processed in the kidneys, there is concern about giving this medication to patients with severe renal damage. The drug might still be so helpful that its use is considered. If it is prescribed for a patient with compromised kidneys, baclofen dosage is usually halved. Physicians may also need to give consideration to other medications a patient might take that could adversely react with this drug.
Medications like baclofen may have severe side effects like seizures, hallucinations, and irregular heart rhythms. Minor but uncomfortable adverse reactions include diarrhea or constipation, general tiredness and fatigue, or difficulty sleeping. These side effects are more likely to occur as the dose increases. Therefore, patient response is carefully monitored, and the goal is to find the lowest effective baclofen dosage. Sometimes, patients may require increased doses if they use the drug for longer periods.
Another consideration with baclofen dosage is that the drug does create some dependency. Just as the medication is carefully initiated, it must also be cautiously discontinued. Stopping baclofen abruptly may cause withdrawal symptoms.