Lioresal is a prescription medication approved by the Food and Drug Administration (FDA) for treating spasticity in children and adults with multiple sclerosis (MS). Lioresal is also sold as a generic under its drug name, Baclofen. Lioresal is not a cure for MS, but it can relieve the cramping, muscle tightness and spasms caused by MS. Lioresal may not be appropriate for pregnant women or women who might become pregnant. Lioresal may not be appropriate for people who are also taking medications that depress the nervous system such as antihistamines, narcotic pain relievers, other muscle relaxants or seizure medications. Avoid drinking alcohol while taking Lioresal.
Lioresal is a muscle relaxant. It is believed that Lioresal works by activating the gamma-aminobutyric acid (GABA) receptors on nerve cells, inhibiting the excitability of the nerves and decreasing muscle tension.
How do I take it?
Lioresal can be administered in two ways, orally and intrathecally (by spinal pump).
Lioresal is generally given orally. When you first begin taking Lioresal, your doctor will start you on a very low dose, such as 5 mg every six to eight hours. You may be told to increase your dose by 5 mg per day until you begin feeling an improvement in spasticity symptoms. Effective doses vary widely between people.
If you decide to stop taking Lioresal, it is very important to gradually taper off your dosage before stopping completely. If you stop taking Lioresal suddenly without tapering off, you may suffer symptoms of withdrawal. Consult your doctor on how best to taper off your dosage.
Those who do not respond to Lioresal or other muscle relaxants taken orally may be considered for an intrathecal pump, also known as intrathecal baclofen therapy, or ITB. This route has the benefit of requiring much smaller amounts of the drug in order to be effective, thereby minimizing side effects. However, placing the pump requires surgery. The pump consists of a titanium disk containing a battery, a reservoir and a computer chip, plus a silicone tub connecting the pump to the intrathecal space. Before performing the placement surgery, your doctor will test your reaction to intrathecal Lioresal by injecting a dose directly into your spine via lumbar puncture. Some people have no response to this administration route; if you do not, you are not a good candidate for the intrathecal pump.
If you do respond well to the injection, the pump will be inserted via two incisions, one in the lower abdomen and one in the lower back. Delivery of the medication is controlled by the computer chip and can be adjusted remotely. The pump is refilled every four to 12 weeks by injection in a brief procedure. It is important not to miss your refill appointments. The battery lasts five to seven years. The chip makes an alarm sound if the reservoir requires refilling, if the battery is low, or if the pump malfunctions. Contact your doctor immediately if the alarm sounds.
Always follow your doctor’s instructions exactly when taking Lioresal.
Baclofen (Lioresal) was approved by the FDA in 1977 on the basis of a five-week clinical trial. The study showed that Baclofen was effective in relieving the symptoms of spasticity in 106 people with multiple sclerosis.
The FDA approved Baclofen delivery via intrathecal pump in 1992 on the basis of several successful studies. Since that time, more than 60,000 pumps have been placed.
There are several side effects that are common when you begin taking Lioresal either orally or intrathecally, but which usually go away after a few weeks. These include drowsiness, increased weakness or tiredness, confusion, headaches, nausea, new or unusual bladder problems or constipation, diarrhea, trouble sleeping, dizziness or lightheadedness, or unusual clumsiness or lack of balance. Contact your doctor if these persist past a few weeks, or if they are intolerable.
Other symptoms are unusual and dangerous. Seek medical attention immediately if you experience the following. For those receiving Lioresal intrathecally, these include high fever, muscle rigidity, depression, or worse spasticity than before you began taking Lioresal. For those taking Lioresal orally, these symptoms include hallucinations, major mood swings, skin rash or itching, or fainting.
There are also possible side effects specific to intrathecal Lioresal. These may include infections of the insertion site, dislocation of the tube inside the body and inflammatory response caused by the body’s reaction to the foreign material.
If you stop taking Lioresal orally without tapering off correctly, or if your intrathecal pump reservoir becomes low, you may experience symptoms of withdrawal. In addition to the return of your spasticity symptoms, withdrawal may include sensations of itching, burning, tingling or crawling; seizures, feelings of dizziness or lightheadedness when standing up, lowered blood pressure, unusual tiredness or weakness, and sweating.
Signs of overdose include sudden blurred or double vision, breathing problems, vomiting, convulsions, and loss of consciousness. Seek medical attention immediately if you experience any of these.
Lioresal can also cause allergic reactions. Get medical help immediately if you experience difficulty breathing or swelling in the face, throat, eyes, lips or tongue.