II. Pathophysiology
- These agents are used to reduce severe spasticity (e.g. Spinal Cord Injury, Cerebral Palsy, Multiple Sclerosis)
III. Indications: Spasticity
IV. Contraindications
- Not indicated for general musculoskeletal problems
V. Preparations
- Dantrolene (Dantrium)
-
Baclofen (Lioresal)
- Baclofen binds GABA B receptors
- Oral Baclofen does not cross blood brain barrier well
- Instead, Baclofen is typically used via Baclofen Intrathecal Pump (due to poor oral absorption)
- Taper off over 1-2 weeks (risk of Hallucinations, Seizures if abruptly stopped)
-
Tizanidine (Zanaflex)
- Dose 4 mg orally every 6-8 hours (maximum 36 mg/day)
- Risk of hepatotoxicity and Blood Pressure changes
- Primarily indicated for spasticity due to Multiple Sclerosis or Spinal Cord Injury
- Clonidine effect (risk of Hypotension and rebound Hypertension)
- Taper off over 1-2 weeks (risk of Clonidine-like rebound Hypertension effect)
VI. References
- (2019) Presc Lett 26(3):15
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Related Studies
| dantrolene (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DANTROLENE SODIUM 100 MG CAP | Generic | $1.24 each |
| DANTROLENE SODIUM 25 MG CAP | Generic | $0.31 each |
| DANTROLENE SODIUM 50 MG CAP | Generic | $0.75 each |