Baclofen is a muscle relaxant that works on the nerves in the brain and spinal cord, reducing the messages that are sent out by the nervous system to cause muscle contraction. It is used in children to treat severe muscle spasm (spasticity), due to cerebral palsy or other conditions that affect the brain or spinal cord. It acts on the whole body and does not target specific muscles.

The benefits of baclofen relaxing muscles include:

Improved ability to move joints
Less pain due to muscle spasm or cramps

While using this medicine – Remember

Try to give Baclofen at about the same times each day. This will help you remember to give it every day.
Side effects due to baclofen usually occur when the medicine is first started. Your doctor will suggest starting with a small dose and increasing slowly to try to minimise side effects.
Do not stop giving Baclofen to your child suddenly as this may cause serious side effects including increased anxiety (worry) behaviour changes, seizures, high temperature, worsening muscle spasm. Any dose changes must be decided by a doctor and the dose must be reduced slowly before stopping.
Signs that too much Baclofen has been taken include excessive sleepiness, trouble breathing, and becoming unconscious. This can be dangerous. If you think someone has taken too much Baclofen, Contact Poisons Information Centre on 13 11 26

Giving my child Baclofen

Your doctor will work out the amount (the dose) that is right for your child. Baclofen is started at a low dose, and slowly increased until a good response is seen. Some patients use baclofen tablets while other patients receive baclofen delivered directly into the spinal cord via a special implanted pump. A lower dose is used via the pump and it may be the best option for some patients.

Baclofen is available as:

Tablets: 10 mg and 25 mg
Injection: 10 mg/ 5 mL, 50 microgram/ mL (for children with implanted pump devices only)

When and how should I give Baclofen?

Baclofen is usually given up to three or four times a day. Baclofen is best tolerated if given with or just after food.

Your doctor will work out the amount (the dose) that is right for your child and it is important to follow your doctor’s instructions about how much to give.

Dosage plan (for tablet administration)

Patient name:
UR Number:			Date of Plan:
Date of Birth:			Prescriber Name:
Use Baclofen _______ mg tablets to make up the doses below
	Week 1 Date: __________	Week 2 Date: __________	Week 3 Date: __________	Week 4 Date: __________
Morning	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg
Lunch	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg
Dinner	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg
Bedtime	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg	____ tablets = ____ mg

Tablets should be swallowed with a glass of water, juice, or similar liquid. Tablets can be cut in half or crushed and mixed with liquid to be given via mouth or feeding tube. Your pharmacist can provide you with details on how to administer crushed or partial tablets.
If your child is receiving baclofen via a pump, it is important to receive training on the pump and how to program it and monitor how it delivers the baclofen. You also need to know what to do to ensure the pump does not run out, stop accidentally or delivers too much baclofen.
You should expect to see some positive effects from the medication after a few days of taking it regularly (three to four days). Your child’s muscles should begin to feel less stiff. It may take up to ten days for the maximum effect to occur. Your doctor will ask you how well the medicine is working and may suggest that you change the amount you give, or when you give it, to get the best effect. Talk to your doctor if you think the dose is not right or the medicine is not working.
If your doctor decides that baclofen is not right for your child, you will need to reduce the dose bit by bit over a few weeks so that your child doesn’t get side-effects. Do not reduce the dose without talking to your doctor first.

What to do if a dose is missed or my child vomits

Never give a double dose of the medicine to catch up a missed dose.

If several doses in a row are missed, contact your doctor for advice.

Give the missed dose as soon as you remember if there are at least four hours before the next oral dose is due. Otherwise skip the missed dose and give the medicine at the normal times. Do not wake your child to give a missed dose.

If your child vomits less than 30 minutes after having a dose by mouth, give them the same dose again. Otherwise wait and give the next dose as normal.

What to do if I give too much Baclofen

If you think your child has had too much Baclofen call the Poisons Information Centre on 13 11 26 even if your child shows no effects. In an emergency, call Triple Zero (000) for an Ambulance or take your child to hospital straight away. Have the medicine packaging with you, even if it is empty, as this information will be useful. Signs that your child has had too much baclofen can include: excessive sleepiness, trouble breathing, and becoming unconscious. This can be dangerous.

What about using other medicines with Baclofen?

Tell your doctor or pharmacist about any other medicines or products your child takes before starting Baclofen. This includes prescription, over the counter medicines, vitamins, supplements, herbal or complementary medicines that you buy from a pharmacy, supermarket, health food shop or online.

Check with your doctor or pharmacist before starting new medicines or products in your child.

You can give your child medicines that contain paracetamol or ibuprofen (to treat pain and fever), unless your doctor has told you not to.
Baclofen should not be taken with some other medicines that you get on prescription or over the counter. Tell your doctor and pharmacist about any other medicines your child is taking before starting baclofen.
If your child is receiving baclofen via a pump, it is important to tell all healthcare professionals that this is your child’s regular therapy.

Possible side effects – what other effects can occur?

Side effects you must do something about

Take your child to hospital or call Triple Zero (000) for an Ambulance if your child has:

A seizure (fit or convulsion)
Shallow or slow breathing or stops breathing
Difficulty being woken up (your child becomes very sleepy)
Urinary retention (passing less urine than normal or feeling that their bladder is full but can’t be emptied), especially if it happens suddenly

Other side effects you need to know about

Some side effects go away with time or after the dose has been changed. Speak to your doctor if you are worried about any of the following, or if they continue:

Sleepiness (feeling sleepy or sluggish). This can last for a few hours after a dose is taken.
Low muscle tone (muscles become very floppy). Your child may need a smaller dose. Seek help from your doctor.
Stomach upset (feeling sick or vomiting). Give baclofen with food. If your child feels sick for more than one day, contact your doctor.
Mood changes (confusion, nightmares, feeling more happy or more sad than normal, or changes in sleep pattern). If you are concerned about your child’s mood, contact your doctor.
Dry mouth (less saliva than normal). Sucking on a sugar-free sweet or using a mouth spray may help.
Change in bladder function (weeing less often than usual, or passing urine without meaning to). If you are concerned, contact your doctor.

There may be other side effects that are not listed above. Contact your doctor if you notice anything unusual and you are concerned about your child.

General medicine advice

Only give this medicine to your child who was prescribed it. Never give it to anyone else, even if their condition appears to be the same, as this could do harm. Contact Poisons Information Centre on 13 11 26 if another person takes this medicine.

Always have valid prescriptions and enough supply of Baclofen.

Store Baclofen in a cupboard (a cool dry place away from heat, direct sunlight and moisture), below 25 ^oC, out of sight and where children cannot reach it. Always keep medicine in the container or box that it came in. Dispose of expired medicines or medicines you no longer need to your pharmacy.

For more information

This fact sheet is about using this medicine in children and young people. Some information may be different from the manufacturer’s Consumer Medicine Information (CMI). The manufacturer’s CMI is found at NPS MedicineWise. These should be read together.

Talk to your doctor, nurse or pharmacist.

Contact us

In an emergency, always contact Triple Zero (000) for immediate assistance

Pharmacy Department
Level 2, Queensland Children’s Hospital
501 Stanley Street, South Brisbane 4101
t: 07 3068 1901 (9am – 5pm Mon – Fri)
(9am – 12pm Sat – Sun/public holidays)