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Haemodialysis clearance of baclofen

  • Pharmacokinetics and Disposition
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Abstract

Background Baclofen is a centrally acting gamma-aminobutyric acid agonist used for spasticity of spinal origin and mainly excreted unchanged by the kidneys. We report haemodialysis clearance and the haemodialysis removal rate constant of baclofen in a comatose patient with baclofen overdose due to acute renal failure.

Case report A 60-year-old man with spastic tetraplegia on chronic baclofen therapy was admitted due to pneumonia and acute renal failure. The patient became comatose and, as a result of the baclofen dosage being left unchanged despite a deterioration leading to renal failure due to hypotension, the concentration of baclofen was determined to be in the toxic range (0.70 mg/L). During a 4-hour-long bicarbonate haemodialysis the patient woke up and became completely orientated and cooperative. Baclofen therapy was subsequently stopped, and the patient remained conscious. The pharmacokinetics calculations revealed a baclofen haemodialysis removal rate constant of 0.152 h-1 and a haemodialysis clearance of 2.14 mL/s.

Conclusions Patients on a stable baclofen regime can develop baclofen toxicity due to acute renal failure. Haemodialysis removes baclofen as effectively as normal kidneys, and it would appear that haemodialysis is a reasonable treatment modality in patients with accidental baclofen overdose due to acute renal failure.

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References

  1. Perry HE, Wright RO, Shannon MW, Woolf AD (1998) Baclofen overdose: drug experimentation in a group of adolescents. Pediatrics 101(6):1045–1048

    Article  PubMed  CAS  Google Scholar 

  2. Young RR, Delwaide PJ (1981) Drug therapy: spasticity. N Engl J Med 304(2):96–99

    Article  PubMed  CAS  Google Scholar 

  3. Faigle JW, Keberle H (1972) The chemistry and kinetics of Lioresal. Postgrad Med J 48(5):9–13

    PubMed  CAS  Google Scholar 

  4. Wuis EW, Dirks MJ, Termond EF, Vree TB, Van der Kleijn E (1989) Plasma and urinary excretion kinetics of oral baclofen in healthy subjects. Eur J Clin Pharmacol 37(2):181–184

    Article  PubMed  CAS  Google Scholar 

  5. Eriksson G, Swahn CG (1981) Concentrations of baclofen in serum and breast milk from a lactating woman. Scand J Clin Lab Invest 41(2):185–187

    PubMed  CAS  Google Scholar 

  6. Chen KS, Bullard MJ, Chien YY, Lee SY (1997) Baclofen toxicity in patients with severely impaired renal function. Ann Pharmacother 31(11):1315–1320

    PubMed  CAS  Google Scholar 

  7. Himmelsbach FA, Kohler E, Zanker B, Wandel E, Kramer G, Poralla T, Meyer zum Buschenfelde KH, Kohler H (1992) Baclofen intoxication in chronic hemodialysis and kidney transplantation. Dtsch Med Wochenschr 117(19):733–777

    Article  PubMed  CAS  Google Scholar 

  8. Wu VC, Lin SL, Lin SM, Fang CC. Treatment of baclofen overdose by haemodialysis: a pharmacokinetic study. Nephrol Dial Transplant 20(2):441–443

  9. Peces R, Navascues RA, Baltar J, Laures AS, Alvarez-Grande J (1998) Baclofen neurotoxicity in chronic haemodialysis patients with hiccups. Nephrol Dial Transplant 13(7):1896–1897

    Article  PubMed  CAS  Google Scholar 

  10. Bassilios N, Launay-Vacher V, Mercadal L, Deray G (2000) Baclofen neurotoxicity in a chronic haemodialysis patient. Nephrol Dial Transplant 15(5):715–716

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Poison Control Centre, University Medical Centre Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia

    Miran Brvar

  2. Institute for Pathophysiology, Medical Faculty, Zaloska cesta 4, 1000, Ljubljana, Slovenia

    Miran Brvar & Matjaz Bunc

  3. Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Matjaž Vrtovec

  4. Department for Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Damjan Kovač

  5. Institute of Forensic Medicine, Medical Faculty, Korytkova 2, 1000, Ljubljana, Slovenia

    Gordana Kozelj & Tomaz Pezdir

  6. Department for Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Matjaz Bunc

Authors
  1. Miran Brvar
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  2. Matjaž Vrtovec
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  3. Damjan Kovač
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  4. Gordana Kozelj
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  5. Tomaz Pezdir
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  6. Matjaz Bunc
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Correspondence to Miran Brvar.

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Brvar, M., Vrtovec, M., Kovač, D. et al. Haemodialysis clearance of baclofen. Eur J Clin Pharmacol 63, 1143–1146 (2007). https://doi.org/10.1007/s00228-007-0371-8

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  • DOI: https://doi.org/10.1007/s00228-007-0371-8

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