Spakem 10 mg Tablet

Muscle relaxant (GABA-B agonist) for:

• Muscle spasticity from multiple sclerosis, spinal cord injury or disease
• Spasticity from cerebral palsy, stroke or brain injury
• Off-label: hiccups, alcohol dependence (specialist use)

Adults: start 5 mg three times daily; increase by 5 mg per dose every 3 days; usual 30–60 mg/day in 3 divided doses; maximum 100 mg/day (specialist).

Children: 0.3 mg/kg/day in divided doses to start, increased gradually (usual 0.75–2 mg/kg/day), as prescribed.

Kidney impairment / elderly: much lower doses (e.g. 5 mg daily).

• Take with food or milk.
• Never stop suddenly — reduce over 1–2 weeks (risk of hallucinations, seizures, high fever, worsening spasm).

• Allergy to baclofen
• Active peptic ulcer (relative)

Very common/common: drowsiness, sleepiness, dizziness, weakness, tiredness, nausea, confusion, headache, low mood, unsteadiness.

Less common: low blood pressure, breathing depression at high doses, frequent urination, constipation, visual changes.

Serious: withdrawal reactions on sudden stopping; worsening of seizures; encephalopathy in kidney failure.

• Drowsiness — avoid driving and alcohol.
• Use with caution in epilepsy, mental illness, stroke, breathing problems, liver disease, diabetes and kidney impairment.
• Some spasticity may be needed for standing/walking — dose carefully.

Use in pregnancy only if clearly needed (withdrawal seizures reported in newborns). Small amounts in breast milk — probably acceptable at usual doses.

• Alcohol, opioids, sedatives, antihistamines, tricyclic antidepressants (more drowsiness, breathing depression)
• Blood-pressure medicines (more lowering)
• Levodopa (confusion, hallucinations)
• Lithium (worsened movement disorders)

Severe drowsiness, weakness, slow breathing, seizures, coma — especially in kidney failure. Emergency care.

Store below 30°C.