From the Guidelines
The maximum dose of baclofen is 80 mg per day [ 1 ].
Typical Dosing Range
The typical dosing range is 40-80 mg per day, divided into 3-4 doses [ 1 ].
Dose Titration
It is generally recommended to start with a low dose, such as 5-10 mg per day, and gradually increase as needed and tolerated, with a maximum single dose of 20 mg.
Special Considerations
In cases with severe liver disease, a more gradual increase in dose is recommended [ 1 ].
- A low dose of 10 mg/day can be used, with a weekly increase of 10 mg/day up to 30 mg/day for patients with muscle cramps [ 1 ].
Key Points
- The presence of liver disease does not generally affect the prescribing of baclofen at the doses recommended [ 1 ].
- Baclofen can be prescribed up to 80 mg/d in patients with liver disease [ 1 ].
From the Research
Maximum Dose of Baclofen
The maximum dose of baclofen varies depending on the specific use and patient population.
- For oral baclofen, the conventional maximum daily dose is 80 mg [ 2 ].
- However, some studies have reported the use of higher doses, up to 630 mg/day, in patients with alcohol use disorders [ 3 ].
- For intrathecal baclofen therapy, the daily dose can be increased by 5% to 15% every 24 hours for adults with cerebral-origin spasticity, and 10% to 30% every 24 hours for adults with spinal-origin spasticity [ 4 ].
Dosing Protocols
Different dosing protocols have been used in various studies, including:
- Starting doses ranging from 5 to 50 mg/day, with titration regimens varying by study [ 3 ].
- Dose escalation studies have also been conducted, with doses ranging from 10 to 20 mg/day for oral baclofen and 7.5 to 15 mg for intravenous baclofen [ 5 ].
Safety and Efficacy
The safety and efficacy of high-dose baclofen therapy have been evaluated in several studies, with varying results.