From the Research
Baclofen dosing for children should start at 0.3 to 1.0 mg/kg/dose, as prescribed, with careful monitoring for side effects and adjustment of the dose as needed and tolerated, based on the most recent and highest quality study available 1. The dosing of baclofen for pediatric patients is crucial for managing spasticity related to cerebral palsy, spinal cord injuries, or multiple sclerosis.
- The medication works by acting on GABA-B receptors in the spinal cord to reduce muscle spasticity.
- Treatment should be initiated at the lowest possible dose and increased slowly to minimize side effects like drowsiness, dizziness, and weakness.
- Any dosing adjustments should be made under medical supervision, and parents should monitor for side effects.
- It's also important to note that baclofen should never be stopped abruptly as this can cause serious withdrawal symptoms including hallucinations, seizures, and high fever, as highlighted in a case report of baclofen toxicity mimicking brain death in a pediatric patient 2.
- The maximum daily dose depends on the child's weight, and effectiveness should be regularly evaluated by the prescribing physician.
- A study on the stability of baclofen in an oral powder form compounded for pediatric patients in Japan found that baclofen concentrations ranged from 90.0% to 110.0% of the initial concentration under all storage conditions, providing assurance for the quality of compounded products 1.
- Another study discussed the importance of proper management and dosing of intrathecal baclofen pump systems to avoid complications such as overdose, underdosing, or withdrawal 3.
- Best practices for intrathecal baclofen therapy, including dosing and long-term management, have been outlined by an expert panel, emphasizing the need for individualized and multistep approaches to dosing 4.
- Additionally, a retrospective review of baclofen treatment for children with rumination syndrome found that nearly half of the patients improved after baclofen, with minimal side effects, suggesting its potential use in this condition as well 5.