Liorel 10

Indications

Liorel is prescribed for the management of:

• Spasticity associated with multiple sclerosis
• Flexor spasms accompanied by pain, clonus, and muscle rigidity
• Skeletal muscle spasms due to rheumatic disorders
• Spinal cord injuries and other spinal cord diseases
• Cerebrovascular accidents or conditions like neoplastic or degenerative brain disease

Use only as directed by a licensed healthcare provider.

Pharmacology

Liorel contains Baclofen, which works by inhibiting both monosynaptic and polysynaptic reflexes at the spinal cord level. It does so by stimulating the GABAB receptors, which suppress the release of glutamate and aspartate. Baclofen also exerts CNS depressant effects and has an antinociceptive action, helping to relieve pain.

Dosage & Administration

• Adults & children over 10 years: 5 mg 3 times daily, preferably with meals. Dose may be gradually increased, with a maximum of 100 mg per day.
• Children under 10 years: Start with 2.5 mg (2.5 ml) four times daily, adjusting based on the child’s needs. The daily maintenance dose is as follows:
  • 12 months-2 years: 10-20 mg (10-20 ml)
  • 2-6 years: 20-30 mg (20-30 ml)
  • 6-10 years: 30-60 mg (30-60 ml)

Always follow the recommendations of a registered healthcare provider.

Interactions

• CNS depressants such as alcohol or synthetic opioids may enhance sedation and increase the risk of respiratory depression when combined with Liorel.
• Combining Liorel with antihypertensive medications may lead to a more pronounced drop in blood pressure. Adjustments to antihypertensive therapy may be required.
• Tricyclic antidepressants and Liorel together can enhance the effects of Baclofen, potentially leading to excessive muscle relaxation.
• In patients with Parkinson’s disease, using Liorel with levodopa and carbidopa may cause mental confusion, hallucinations, headaches, nausea, and agitation.
• The combination of MAO inhibitors and Liorel could intensify CNS depression; caution is advised.
• Magnesium sulphate and other neuromuscular blocking agents may interact with Liorel, potentially increasing their effects.

Contraindications

Liorel should not be used by individuals with a known hypersensitivity to any component of the product.

Side Effects

Common side effects include drowsiness, daytime sedation, dizziness, weakness, and fatigue. Serious reactions may include:

• CNS-related: Headache, insomnia, euphoria, confusion, hallucinations, muscle pain, tinnitus, slurred speech, and in rare cases, seizures or respiratory depression.
• Cardiovascular: Hypotension, rare instances of dyspnea, chest pain, and syncope.
• Gastrointestinal: Nausea, constipation, and rarely, dry mouth, anorexia, abdominal pain, vomiting, and diarrhea.
• Genitourinary: Urinary frequency, retention, or impotence may occur.
• Other effects: Rash, pruritus, edema, excessive sweating, and potential liver function changes. Muscle hypotonia can occur but is generally relieved by adjusting the dosage.

Pregnancy & Lactation

Liorel is Category B3 for pregnancy. The safety of Baclofen during pregnancy has not been fully established, as it crosses the placental barrier. It should only be used if the benefits outweigh the risks, based on the physician’s judgment. Baclofen is excreted in breast milk, but in small amounts that are unlikely to harm the infant.

Precautions & Warnings

• Renal impairment: Use lower doses, especially in patients with kidney dysfunction or those undergoing chronic dialysis.
• Psychiatric conditions: Patients with psychotic disorders, including schizophrenia or manic depression, should be monitored closely when taking Baclofen.
• Epilepsy: Baclofen may lower the seizure threshold. It should be used with caution in epileptic patients, ensuring anticonvulsive therapy is continued.
• Peptic ulcers, cerebrovascular diseases, or organ failure: Liorel should be used with caution in individuals with these conditions.
• Respiratory and cardiovascular monitoring: Essential for patients with existing cardiopulmonary diseases.
• Urinary retention: Patients with pre-existing sphincter hypertonia may experience acute retention of urine.

Overdose Effects

In case of overdose, gastric lavage is important. Seek immediate medical attention.

Therapeutic Class

Centrally Acting Skeletal Muscle Relaxants

Storage Conditions

Store below 30°C, away from light and moisture. Keep out of reach of children.