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Thread: high dose of oral Baclofen

  1. #1
    Senior Member jessie.gray's Avatar
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    high dose of oral Baclofen

    How high of a dose of oral Baclofen do you have to be on before a doctor or insurance will consider putting a Baclofen Pump in? I am currently on 80mg daily and I still get spasms in my legs (mostly during the day).

    Jessie

  2. #2
    Jessie,

    I was up to 100mg a day at one point and it seemed to do little for me. I knew I wasn't going to increase the dosage or gt a pump so I fought through them. A few months ago I realized that my spasms were brought on by stool in my rectum. (something like having to take a poop really badly, but having to hold it as an AB! Remember how uncomfortable that was? LOL) Now I know that when I get bad spasms, I should do a quick B/P and clean myself out. Now I take 20mg a day, and I'll probably eliminate that soon.

    My point is this, maybe there is something else influencing or causing your spasms. Look for, and eliminate those things and you should be able to decrease your dosage.

    On the days of your worst spasms.....do you have a large evacuation of stool? Is there stool in your rectum at the beginning of your program? Yours could be bladder related too....

    I hope you figure it out!

    Dave
    Last edited by Herco16; 07-15-2008 at 03:14 PM.
    Dave

  3. #3
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    Also, the severity of the spasms is a factor.

  4. #4
    Have you tried Zanaflex?

  5. #5
    I've heard several times that 80-100mg is the maximum daily oral dose, but I've never heard why. Is it hard on the liver/kidneys? Does it cause weakness?

    I didn't think the baclofen was doing anything until I ran out of it once, that was one night in hell. Maybe a gradual decrease in dosage might work, but given the severity of my spasticity I think I'm heading toward the pump.

  6. #6
    Senior Member Mona~on~wheels's Avatar
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    I take 120 mg a day. 20 mg at a time, every 4 hrs.
    My Dr said that was the max, and I'm sure it's bad on the liver.
    My legs are completely flacid.
    If I have a spasm I know I missed my medicine.
    I sleep by myself all night and my legs were uncontrolable.
    But now no problem.

  7. #7
    Quote Originally Posted by Mona~on~wheels
    I take 120 mg a day. 20 mg at a time, every 4 hrs.
    My Dr said that was the max, and I'm sure it's bad on the liver.
    My legs are completely flacid.
    If I have a spasm I know I missed my medicine.
    I sleep by myself all night and my legs were uncontrolable.
    But now no problem.
    Mona, why are you taking such a high dose? There is no need to keep your legs completely flaccid. Are you getting up every 4 hours at night to take a dose of baclofen?

    Wise.

  8. #8
    Quote Originally Posted by Zero
    I've heard several times that 80-100mg is the maximum daily oral dose, but I've never heard why. Is it hard on the liver/kidneys? Does it cause weakness?

    I didn't think the baclofen was doing anything until I ran out of it once, that was one night in hell. Maybe a gradual decrease in dosage might work, but given the severity of my spasticity I think I'm heading toward the pump.
    Zero, the limit is about 120 mg/day because it starts to cause sleepiness and other problem for the brain at higher doses. Baclofen is not known to be hepatotoxic or renal toxic at 120 mg/day. If your problem is at night, one of the questions is whether or not your dose can be increased at night and lowered during the day.

    Wise.

  9. #9
    Senior Member Mona~on~wheels's Avatar
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    Quote Originally Posted by Wise Young
    Mona, why are you taking such a high dose? There is no need to keep your legs completely flaccid. Are you getting up every 4 hours at night to take a dose of baclofen?

    Wise.
    I plead the 5th. I didn't know I shouldn't.
    My aide would position me on my side to sleep,
    and 15 minutes later I'd be on my back all messed up.
    So I told my Dr. (family Dr.) and he switced me from 10 mg to 20 mg.
    That was 12-15 yrs. ago.
    I'll try to cut back but it's hard when you're use to being still.
    My medicine is by my bed & I take it in the night.

  10. #10
    Until the spasm interfere with your daily life severely, I would stick with the oral dose. My spasms got severe enough where my legs were taking straight out, I was getting pulled over the side of my chair, my fingers were clenched closed, and it would straighten out my back causing me to slide down in my chair. I tried everything before I tried the pump with very little results. When I had it removed a couple of years ago for a month because it was infected, I couldn't even get out of bed the whole time because I was so spastic. Every little touch and every little move I made with set up severe spasms. If that's what you're dealing with, go for the pump. It's really helped me out quite a bit.
    C-5/6, 7-9-2000
    Scottsdale, AZ

    Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

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