Baclofen Toxicity in Kidney Disease

Erin Wolf, Niraj R. Kothari, John K. Roberts, Matthew A. Sparks

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Baclofen, a commonly prescribed muscle relaxant, is primarily excreted via the kidneys; toxicity is a potentially serious adverse outcome in patients with decreased kidney function. We describe a patient with end-stage kidney disease receiving hemodialysis who developed neurotoxicity and hemodynamic instability after receiving baclofen for muscle spasms. In this case, prompt recognition of baclofen toxicity and urgent hemodialysis were effective in reversing this toxicity. This case is used to examine the pharmacokinetics and pathophysiology of baclofen toxicity and discuss appropriate diagnosis and management of baclofen toxicity. We recommend reducing the baclofen dose in patients who have moderately reduced kidney function (estimated glomerular filtration rate, 30-60 mL/min/1.73 m2) and avoiding use in patients with severely reduced kidney function (estimated glomerular filtration rate < 30 mL/min/1.73 m2) or on renal replacement therapy.

Original languageEnglish (US)
Pages (from-to)275-280
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume71
Issue number2
DOIs
StatePublished - Feb 2018
Externally publishedYes

Keywords

  • Baclofen
  • creatinine clearance
  • decreased kidney function
  • drug dosing
  • drug toxicity
  • end-stage kidney disease (ESKD)
  • hemodialysis
  • muscle relaxant
  • pharmacokinetics
  • renal clearance

ASJC Scopus subject areas

  • Nephrology

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