What is the appropriate dose and duration of baclofen (GABA_B receptor agonist) for treating vomiting?

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From the FDA Drug Label

The determination of optimal dosage requires individual titration. Start therapy at a low dosage and increase gradually until optimum effect is achieved (usually between 40 to 80 mg daily). The following dosage titration schedule is suggested: 5 mg t.i.d. for 3 days 10 mg t.i.d. for 3 days 15 mg t.i.d. for 3 days 20 mg t.i.d. for 3 days Thereafter additional increases may be necessary but the total daily dose should not exceed a maximum of 80 mg daily (20 mg q.i.d.).

The FDA drug label does not answer the question.

From the Research

Baclofen Dosage and Duration for Treating Vomiting

  • The appropriate dose of baclofen for treating vomiting is 10 mg, three times daily 1, 2.
  • This dosage has been shown to be effective in reducing symptoms of rumination syndrome and gastroesophageal reflux disease (GERD) in both adults and children 1, 3, 2.
  • The duration of treatment with baclofen can vary, but studies have shown that it can be effective for both short-term and long-term use 4, 3.
  • In one study, patients with refractory GERD were treated with baclofen for up to 12 months, with 81% of patients experiencing a sustained response to treatment 3.

Efficacy of Baclofen in Treating Vomiting

  • Baclofen has been shown to be effective in reducing transient lower esophageal sphincter relaxations (TLESRs), postprandial acid reflux events, and median number of acid-related symptoms in patients with GERD 4, 5.
  • In patients with rumination syndrome, baclofen has been shown to reduce symptoms of regurgitation and improve quality of life 1, 2.
  • Baclofen can be used as supplemental therapy to proton pump inhibitors (PPIs) in children with refractory GERD, with 66% of patients experiencing a significant reduction in clinical symptoms at their first follow-up visit 3.

Side Effects and Limitations

  • Common side effects of baclofen include drowsiness and dizziness 4, 5.
  • Baclofen may not be effective in all patients, with some studies showing that up to 19% of patients may lose response to treatment over time 3.
  • Further studies are needed to fully understand the efficacy and safety of baclofen in the treatment of vomiting and GERD 4, 3, 5.

References

Research

Diagnosis and Treatment of Rumination Syndrome.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018

Research

Rumination syndrome: when to suspect and how to treat.

Current opinion in gastroenterology, 2019

Research

Baclofen for the treatment of pediatric GERD.

Journal of pediatric gastroenterology and nutrition, 2013

Research

The Role of Baclofen in the Treatment of Gastroesophageal Reflux Disease.

The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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