From the Guidelines
Baclofen is generally more effective for neurological spasticity, while Robaxin (methocarbamol) is better suited for general musculoskeletal pain and spasms. The choice between baclofen and Robaxin depends on the specific condition being treated.
- Baclofen works on the GABA-B receptors in the spinal cord and is most effective for spasticity from conditions like multiple sclerosis or spinal cord injuries, typically starting at 5-10mg three times daily and potentially increasing to 20-25mg per dose 1.
- Robaxin acts centrally as a general muscle relaxant and is often used for acute muscle spasms from strains or injuries, usually dosed at 1500mg four times daily initially, then 750mg every 4 hours as needed. Side effect profiles differ:
- Baclofen commonly causes drowsiness and weakness but can cause serious withdrawal if stopped abruptly.
- Robaxin typically causes milder sedation and dizziness. There is limited evidence comparing the two medications directly, but the most recent and highest quality study suggests that skeletal muscle relaxants, including Robaxin, are moderately superior to placebo for short-term pain relief in acute low back pain 1. However, baclofen has some data to support its use in stroke patients, although it may cause significant sedation and have less impact on spasticity in stroke victims 1. Ultimately, the choice between baclofen and Robaxin should be determined by a doctor based on the patient's specific diagnosis, medical history, and other medications they take.
From the Research
Comparison of Baclofen and Robaxin
- Baclofen is generally considered the drug of choice for spinal cord types of spasticity 2
- There is no direct comparison between baclofen and robaxin in the provided studies
- Baclofen has been shown to be effective in reducing spasticity in various studies 3, 4, 5, 6
- Robaxin (methocarbamol) is not mentioned in the provided studies as a comparison to baclofen
Efficacy and Safety of Baclofen
- Oral baclofen may be effective in many patients with spasticity, regardless of the underlying disease or severity 6
- Adverse effects of oral baclofen are common, affecting between 25% and 75% of patients, and limiting its usefulness 6
- Intrathecal baclofen may be an effective alternative, delivering the drug directly into the cerebrospinal fluid and minimizing drug-related side-effects 3, 5, 6
Treatment of Spasticity
- Baclofen is one of the most widely used drugs in treating abnormal or disabling spastic tone 5
- Intrathecal baclofen (ITB) has been shown to be effective in modulating and reducing spastic tone 3, 5
- The management of spasticity can be achieved through the combination of both nonpharmacological and pharmacological approaches 4