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Eur J Clin Pharmacol. 2007 Dec;63(12):1143-6. Epub 2007 Sep 2.

Haemodialysis clearance of baclofen.

Author information

1
Poison Control Centre, University Medical Centre Ljubljana, Zaloska cesta 7, 1000 Ljubljana, Slovenia. miran.brvar@kclj.si

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.

PMID:
17764008
DOI:
10.1007/s00228-007-0371-8
[Indexed for MEDLINE]

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