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Mylofen (Baclofen) is indicated for managing:
✅ Neurological Spasticity:
Multiple sclerosis
Spinal cord injuries/diseases
Post-stroke rigidity
Traumatic brain injury sequelae
✅ Musculoskeletal Disorders:
Painful flexor spasms & clonus
Rheumatic disorder-related muscle spasm
Baclofen is a GABA-B receptor agonist that:
Inhibits monosynaptic/polysynaptic reflexes at spinal level
Reduces glutamate/aspartate release → decreases muscle hypertonia
Exerts central antinociceptive (pain-blocking) effects
| Patient Group | Initial Dose | Maintenance Range | Max Daily |
|---|---|---|---|
| Adults & >10y | 5 mg TID | Titrate slowly | 100 mg |
| Children 6-10y | 2.5 mg QID | 30-60 mg/day | - |
| Children 2-6y | 2.5 mg QID | 20-30 mg/day | - |
| Infants 1-2y | 2.5 mg QID | 10-20 mg/day | - |
Critical Notes:
Always take with food to reduce GI side effects
Titrate gradually (over weeks) to minimize sedation
Renal impairment: Start with 5 mg/day
❌ Absolute Contraindications:
Hypersensitivity to baclofen
Abrupt discontinuation (risk of withdrawal seizures)
⚠️ High-Risk Populations:
Psychiatric disorders: May exacerbate psychosis/depression
Epilepsy: Monitor seizure threshold (adjust anticonvulsants)
Renal impairment: Requires dose reduction
Peptic ulcer/CVD: Use with extreme caution
| Common (>10%) | Serious (Monitor Closely) |
|---|---|
| • Daytime sedation | • Respiratory depression |
| • Dizziness/fatigue | • Hallucinations/confusion |
| • Nausea | • Severe hypotension |
| • Urinary frequency | • Paradoxical spasticity increase |
| Concomitant Drug | Risk | Action Required |
|---|---|---|
| CNS Depressants | ↑ Sedation/respiratory failure | Avoid alcohol/opioids |
| Antihypertensives | Profound hypotension | Adjust BP med doses |
| Levodopa | Nausea/agitation/psychosis | Avoid combination |
| TCAs/MAOIs | Potentiated muscle hypotonia | Monitor neuromuscular function |
Pregnancy (Category B3): Use only if benefit >> risk (crosses placenta)
Breastfeeding: Low milk excretion → likely safe
Elderly: Start with 2.5 mg BID (↑ sensitivity to effects)
Renal Patients: Max 5 mg/day if CrCl <30 mL/min
Symptoms: Coma, respiratory depression, bradycardia
Treatment:
Gastric lavage + activated charcoal
IV fluids for hypotension
Mechanical ventilation if needed
No specific antidote
Centrally-Acting Skeletal Muscle Relaxant
✔️ Never stop abruptly - Taper over 1-2 weeks to prevent withdrawal
✔️ Report hallucinations/confusion immediately
✔️ Avoid driving (drowsiness risk)
⚠️ Paradoxical response: Increased spasticity? Contact provider
Below 30°C in original packaging
Protect from light/humidity
Keep locked away from children
Registered চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন
Requires ongoing neurological monitoring
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