Lioresal (Baclofen)

Lioresal is used to manage spasticity in neurological disorders that affect muscle tone. These indications are supported by clinical evidence and are reflected in the product’s marketing authorization in the European Union. Treatment aims to improve functional ability and reduce discomfort associated with excessive muscle tone.

• Multiple sclerosis spasticity: reduces involuntary muscle contractions, improving mobility and daily function.
• Spinal cord injury spasticity: lessens muscle stiffness, facilitating rehabilitation and comfort.
• Cerebral palsy spasticity: diminishes tone abnormalities, aiding posture and movement control.

• Baclofen acts as an agonist at GABA_B receptors in the central nervous system. By stimulating these metabotropic receptors, it inhibits the release of excitatory neurotransmitters and reduces the activity of spinal cord interneurons that mediate reflex muscle contraction. The resulting decrease in neuronal firing dampens the hyperactive stretch reflex, leading to lowered muscle tone and relief of spasticity.

Baclofen may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Drowsiness: feeling unusually sleepy or fatigued.
• Dizziness: light‑headed sensation, especially when standing quickly.
• Weakness: reduced muscle strength or general fatigue.
• Nausea: upset stomach or urge to vomit.
• Headache: mild to moderate head pain.
• Dry mouth: reduced salivation.
• Insomnia: difficulty falling or staying asleep.

Serious or Rare Side Effects

• Seizures: sudden uncontrolled electrical activity in the brain.
• Respiratory depression: slowed or shallow breathing that may require medical attention.
• Allergic reactions: rash, itching, swelling, or anaphylaxis.
• Hallucinations: visual or auditory disturbances.

When prescribing or dispensing Baclofen, several precautions should be observed to ensure safe use.

• Renal impairment: adjust dose and monitor renal function because the drug is excreted unchanged.
• Hepatic disease: use caution; liver dysfunction may increase plasma concentrations.
• Concomitant CNS depressants: avoid additive sedation or respiratory depression.
• Abrupt discontinuation: taper gradually to prevent withdrawal symptoms such as agitation or seizures.
• Pregnancy and lactation: safety not established; weigh potential benefits against risks.
• Store at ambient temperature: keep below 25 °C in the original packaging, protected from moisture and light.

Baclofen can interact with other medicines, altering its effectiveness or increasing adverse effects.

Major Interactions (Avoid)

• Opioids: combined CNS depression may cause severe respiratory depression.
• Benzodiazepines: additive sedative effect increasing risk of profound drowsiness.
• Antihypertensives: may enhance hypotensive response.

Moderate Interactions (Monitor Closely)

• Anticonvulsants: may reduce seizure threshold or require dose adjustments.
• Alcohol: can increase sedation and dizziness.