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LIORESAL INTRATHECAL should be used with caution in patients with a history of autonomic dysreflexiaThe presence of nociceptive stimuli or abrupt withdrawal of LIORESAL INTRATHECALbaclofen injectionmay cause an autonomic dysreflexic episode.

WithdrawalAbrupt withdrawal of intrathecal baclofenregardless of the causehas resulted in sequelae that included high feveraltered mental statusexaggerated rebound spasticity and muscle rigiditythat in rare cases progressed to rhabdomyolysismultiple organ-system failureand deathIn the first 9 years of post-marketing experience27 cases of withdrawal temporally related to the cessation of baclofen therapy were reportedsix patients diedIn most casessymptoms of withdrawal appeared within hours to a few days following interruption of baclofen therapyCommon reasons for abrupt interruption of intrathecal baclofen therapy included malfunction of the catheterespecially disconnectionlow volume in the pump reservoirand end of pump battery lifehuman error may have played a causal or contributing role in some casesCases of intrathecal mass at the tip of the implanted catheter leading to withdrawal symptoms have also been reportedmost of them involving pharmacy compounded analgesic admixturessee PRECAUTIONS

Lioresal is not indicated in the treatment of skeletal muscle spasm resulting from rheumatic disorders.

Considerations based on experience with oral LIORESALbaclofen USPA dose-related increase in incidence of ovarian cysts was observed in female rats treated chronically with oral LIORESALOvarian cysts have been found by palpation in about 4of the multiple sclerosis patients who were treated with oral LIORESAL for up to one yearIn most cases these cysts disappeared spontaneously while patients continued to receive the drugOvarian cysts are estimated to occur spontaneously in approximately 1to 5of the normal female population.

Symptoms of LIORESAL INTRATHECAL OverdoseDrowsinesslightheadednessdizzinesssomnolencerespiratory depressionhypothermiaseizuresrostral progression of hypotonia and loss of consciousness progressing to coma of up to 72 hrdurationIn most cases reportedcoma was reversible without sequelae after drug was discontinuedSymptoms of LIORESAL INTRATHECAL overdose Pyridium over the counter australia were reported in a sensitive adult patient after receiving a 25 mcg intrathecal bolus.

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