Baclofen Toxicity in Patients with Severely Impaired Renal Function

Chen, Kuo-Su; Bullard, Michael J.; Chien, Yu-Yi; Lee, Sheng-Yuan

doi:10.1177/106002809703101108

Cited by 73 publications

(69 citation statements)

References 22 publications

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“…The elimination half-life of baclofen is 2–6 h for therapeutic oral doses in healthy volunteers and elderly patients [4,5], but half-life increases with renal insufficiency [6,7,8,9,10]. Baclofen has a limited hepatic metabolism.…”

Section: Introductionmentioning

confidence: 99%

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Baclofen Toxicity in Patients with Advanced Nephropathy: Proposal for New Labeling

et al. 2011

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Background: Despite several reports in the literature of baclofen toxicity in patients with renal dysfunction, the drug is being used for many patients. Methods: Herein we report a case of baclofen-induced encephalopathy in a patient with pre-end-stage renal disease and review the literature regarding the magnitude of baclofen toxicity in patients with renal insufficiency. A Medline search for studies in English was performed. Twenty-one case reports involving 41 patients (including our patient) were identified. Results: The majority of patients were elderly (62.5% above 60 years) males (56.3%) on dialysis (62.9%). Neurotoxicities were almost always present at presentation. Manifestations of baclofen toxicity usually started 2–3 days after starting baclofen; however, periods as long as 16 weeks have been reported. The daily dose of baclofen ranged from 5 to 60 mg with a mean dose of 20 mg. Hemodialysis (HD) was the most common treatment modality used for drug elimination (65.7%). The recovery time ranged from 2 h in patients who received HD, to 8 days with conservative treatment. Conclusion: The literature does not mention a clear recommendation about baclofen safety and dose adjustment, or a minimum level of kidney function below which the drug should not be used.

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Section: Introductionmentioning

confidence: 99%

“…Therefore, a significant reduction in the daily dose is mandatory in patients with renal insufficiency. Most nephrologists consider baclofen to be a drug that should not be used in patients with end-stage renal disease (ESRD) [7,8,11]. …”

Section: Introductionmentioning

confidence: 99%

Baclofen Toxicity in Patients with Advanced Nephropathy: Proposal for New Labeling

et al. 2011

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“…The appropriate serum level of baclofen in patients with severely impaired renal function remains unclear. Chen et al have thought that patients with renal failure are more susceptible to baclofen toxicity [2]. Similarly our patient had toxicity with a low-dose (50 mg).…”

Section: Discussionmentioning

confidence: 79%

“…Baclofen is eliminated predominantly by the kidneys and patients with impaired renal function have particular risk for baclofen accumulation [1]. Some authors have suggested that haemodialysis is effective in the removal of baclofen, however the pharmakokinetics of baclofen elimination during haemodialysis remains unclear [2]. In this article we report a baclofen intoxication in a patient with chronic renal failure, which was resolved by haemodialysis.…”

Section: Introductionmentioning

confidence: 88%

Baclofen Intoxication in a Patient with Chronic Renal Failure

2016

J Ann Eu Med

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ÖzetBaklofen γ-aminobütirik asit (GABA) türevi olup, spastisite tedavisinde kullanıl-maktadır. Baklofen toksititesi kas gevşemesi, ciddi solunum depresyonu, nöbet, koma, bradikardi/taşikardi ya da hipotansiyon/hipertansiyona neden olabilir. Kronik böbrek yetmezliği olan 60 yaşındaki hastanın düşük doza rağmen baklofen intoksikasyonuna bağlı stupor ile başvurusunu sunduk. Anahtar KelimelerBaklofen İntoksikasyonu, Kronik Böbrek Yetmezliği, Bilinç Bulanıklığı AbstractBaclofen is a derivative of γ-aminobutyric acid (GABA), is used in the treatment of spasticity. Baclofen toxicity can cause muscle flaccidity, severe respiratory depression, seizure, coma, bradycardia/tachcardia, or hypotension/hypertension. We report on a 60-year-old female patient with chronic renal failure who presented with stupor due to baclofen intoxication in spite of low dosage.

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“…Son dönem böbrek yetersizliği olan hastalarda baklofen birikimi olduğu ve yarılanma ömrünün uzadığı belirtilmektedir (19). Yapılan birçok çalışmada renal yetersizliği olan ciddi baklofen toksisite olgularında hemodiyaliz uygulamaları ile serum baklofen kosantrasyonun hızla düştüğü, baklofen yarılanma ömrünün kısaldığı ve klinik semptomların hızla iyileştiği gösterilmiştir (20)(21)(22)(23)(24). Kısıtlı sayıda çalışmada ise normal renal fonksiyonu olan baklofen entoksikasyonu olgularında da hemodiyaliz ile yine aynı faydaların sağlandığı belirtilmektedir (25,26).…”

Section: Discussionunclassified