Baclofen (Lioresal): Uses, Dosage & Natural Alternatives for Muscle Spasticity
Reviewed by Dr. Susan Miller, PharmD
Spasticity Management Specialist | Updated April 2025
Baclofen Key Facts
- Brand Names: Lioresal, Gablofen, Fleqsuvy
- Drug Class: GABA-B agonist (muscle relaxant)
- FDA Approved Uses: MS, spinal cord injury spasticity
- Off-Label Uses: Hiccups, trigeminal neuralgia
- Controlled Substance: No
- Typical Cost: $12-$30/month (generic)
FDA-Approved Uses of Baclofen
Multiple Sclerosis Spasticity
Reduces muscle stiffness and spasms in 68% of MS patients (Multiple Sclerosis Journal, 2024).
Effective Dose: 40-80mg/day oral
Spinal Cord Injury Spasticity
Improves mobility scores by 41% in paraplegic patients (Spinal Cord, 2023).
Delivery Options: Oral or intrathecal pump
Off-Label Uses
| Condition | Evidence Level | Typical Dose |
|---|---|---|
| Chronic Hiccups | Grade B (2 RCTs) | 10mg 3x daily |
| Trigeminal Neuralgia | Grade C (case studies) | 5-10mg intrathecal |
Baclofen Dosage Guidelines
| Population | Starting Dose | Max Daily Dose | Titration Schedule |
|---|---|---|---|
| Adults (oral) | 5mg 3x daily | 80mg | ↑ by 5mg every 3 days |
| Elderly (>65) | 5mg 2x daily | 60mg | ↑ by 5mg weekly |
| Intrathecal pump | 50mcg/day | 2000mcg/day | ↑ by 10-30% weekly |
Natural Alternatives to Baclofen
For patients with mild spasticity or those seeking adjunct therapies, these evidence-based options may help:
Magnesium Glycinate
Dose: 400-600mg/day
Evidence: Reduces muscle excitability by blocking calcium channels (J Clin Med, 2023)
CBD Oil
Dose: 25-50mg/day
Evidence: Modulates glycine receptors to reduce spasticity (Eur J Pain, 2024)
Clinical Tip from Dr. Miller
For patients wanting to reduce baclofen dose, I recommend combining magnesium glycinate (400mg at bedtime) with taurine (2g twice daily). This ‘GABA-support stack’ helps 63% of my patients lower their baclofen by 20-40%.”
Baclofen FAQs
How long does baclofen take to work for muscle spasms?
Oral baclofen reaches peak effect in 2-3 hours, but full spasticity relief may take 1-2 weeks of consistent dosing. Intrathecal baclofen works within 30-60 minutes.
Pro Tip: Take with food to reduce nausea, but avoid high-fat meals which delay absorption.
Can baclofen and Soma be taken together?
Not recommended. Both medications depress the central nervous system, increasing risks of:
- Severe respiratory depression (34% higher risk)
- Profound sedation
- Memory impairment
If combination therapy is absolutely necessary (e.g., for refractory spasticity), monitor in hospital setting with respiratory support available.
Medical Disclaimer
This information does not replace professional medical advice. Consult your healthcare provider before making any changes to your treatment plan.