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LIORESAL (BACLOFEN) TABLETS DRUG INTERACTIONS

Levodopa / Dopa Decarboxylase (DDC) inhibitor (Carbidopa):

In patients with Parkinson's disease receiving treatment with Lioresal and levodopa (alone or in combination with DDC inhibitor, carbidopa), there have been reports of mental confusion, hallucinations, headaches, nausea and agitation. Worsening of the symptoms of Parkinsonism has also been reported. Hence, caution should be exercised during concomitant administration of Lioresal and levodopa/carbidopa.

Drugs causing Central Nervous System (CNS) depression:

Increased sedation may occur when Lioresal is taken concomitantly with other drugs causing CNS depression including other muscle relaxants (such as tizanidine), with synthetic opiates or with alcohol. The risk of respiratory depression is also increased. In addition, hypotension has been reported with concomitant use of morphine and intrathecal baclofen. Careful monitoring of respiratory and cardiovascular functions is essential, especially in patients with cardiopulmonary disease and respiratory muscle weakness.

Antidepressants:

During concomitant treatment with tricyclic antidepressants, the effect of Lioresal may be potentiated, resulting in pronounced muscular hypotonia.

Lithium:

Concurrent use of oral Lioresal and lithium resulted in aggravated hyperkinetic symptoms. Thus, caution should be exercised when Lioresal is used concomitantly with lithium.

Antihypertensives:

Since concomitant treatment with antihypertensives is likely to enhance the fall in blood pressure, the dosage of antihypertensive medication should be adjusted accordingly.

Agents reducing renal function:

Drugs or medicinal products that can significantly impact renal function may reduce baclofen excretion leading to toxic effects.

Others:

Concurrent use of baclofen with monoamine oxidase (MAO) inhibitors may result in increased CNS-depressant and hypotensive effects. Caution is recommended and dosage of one or both agents may require reduction.

Since baclofen may increase blood glucose concentrations, dosage adjustments of insulin and/or oral hypoglycaemic agents may be necessary during and after concurrent therapy.

Studies in rats indicate that the agonistic effects of baclofen on gastric acid secretion are potentiated by diazepam.



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