Baclofen is a muscle relaxant used for spasticity — the stiffness and involuntary spasm that follow damage to the brain or spinal cord, as in multiple sclerosis, spinal injury, stroke and cerebral palsy. It comes as 10 mg and 25 mg tablets, and as an intrathecal infusion for severe cases.

What is Baclofen?

The South African Medicine Price Registry lists baclofen under many names, all Schedule 4:

Product	Form	Strength
Lioresal, Spasifen, Teva Baclofen, Bio-Baclofen, Aspen Baclofen	Tablet	10 mg
Lioresal 25, Aspen Baclofen 25, Baclofen 25 Biotech	Tablet	25 mg
Bacentra Intrathecal	Injection / infusion	0.05 mg/ml and 0.5 mg/ml

Baclofen is a GABA-B receptor agonist. GABA is the nervous system’s main inhibitory signal, and baclofen mimics it at a specific receptor in the spinal cord. That reduces the reflex activity driving spastic muscle tone, allowing muscles to relax.

Importantly, it acts on the central nervous system, not on muscle directly. It quietens the signal telling the muscle to contract.

The intrathecal form is a different proposition entirely. Delivered by a surgically implanted pump directly into the fluid around the spinal cord, it achieves effect at roughly a thousandth of the oral dose, with far less drowsiness. It is reserved for severe spasticity not controlled by tablets. Note the strengths in the table — those are milligrams per millilitre for a route where microgram accuracy matters, and a pump failure is a medical emergency.

What is Baclofen commonly used for?

Multiple sclerosis — spasticity, stiffness and painful spasms. This is its most established use.
Spinal cord injury or disease, including spasms that disturb sleep and interfere with care.
Cerebral palsy, in children and adults.
After stroke or traumatic brain injury, where limb spasticity limits movement.
Muscle spasm from other neurological conditions.
Trigeminal neuralgia, sometimes, as an add-on.
Persistent hiccups. This is a genuine use, and it accounts for a surprising number of searches. Intractable hiccups — lasting more than 48 hours, often in seriously ill patients — is a recognised and distressing problem, and baclofen has some of the best evidence of any treatment for it. Ordinary hiccups need nothing.
Alcohol dependence, in some countries and some specialist settings. Evidence is mixed and it is not a standard treatment here.

It is not for ordinary back or neck pain. Baclofen is often assumed to be a general muscle relaxant for a pulled muscle. It is not — it is for spasticity of neurological origin, and for everyday musculoskeletal pain the sedation outweighs any benefit.

Some spasticity is useful. People with weak legs often rely on a degree of stiffness to stand or transfer. Relaxing it too far can make walking or transferring harder rather than easier. This is why the dose is titrated carefully to a functional goal, not simply pushed until muscles are loose.

How Baclofen fits into this medicine category

Group	Examples	Where it fits
Centrally acting antispastics	Baclofen, tizanidine	Spasticity from neurological disease
Direct muscle relaxants	Dantrolene	Acts on muscle itself
Benzodiazepines	Diazepam	Spasm and spasticity; sedation and dependence
Botulinum toxin	Injections	Focal spasticity in specific muscles
Simple analgesics	Paracetamol (Donapan)	Pain, not spasticity
Corticosteroids	Prednisone	Inflammation, including MS relapses

Physiotherapy sits alongside all of these and does more for function than any of them alone. See the pain, inflammation and musculoskeletal medicines hub.

What to check before using Baclofen

Never stop baclofen suddenly. This is the most important safety point on this page. Abrupt withdrawal — from tablets and especially from an intrathecal pump — can cause a severe reaction: rebound spasticity worse than before, high fever, confusion, agitation, hallucinations, seizures, and in extreme cases rhabdomyolysis, organ failure and death. Any reduction must be gradual and planned. Never let a prescription run out.

Tell your doctor or pharmacist if you:

Have kidney disease. Baclofen is cleared by the kidneys, and the dose must be reduced — most cases of baclofen toxicity trace back to unrecognised kidney impairment.
Have epilepsy. Baclofen can lower the seizure threshold.
Have peptic ulcer disease, diabetes, liver disease or breathing problems.
Have a history of mental illness or confusion, or are elderly.
Have difficulty passing urine.
Take sedating medicines — benzodiazepines, opioids, sleeping tablets, antihistamines — or drink alcohol. The sedation adds up.
Take blood pressure medicines or tricyclic antidepressants, which can amplify the blood-pressure-lowering effect.
Are pregnant or breastfeeding.

Practical points:

Take it with or after food to reduce nausea.
Follow the titration — the dose is built up gradually over weeks.
Do not drive until you know how it affects you.
Report a loss of useful stiffness, not just remaining spasm — the goal is function, not maximum relaxation.
For a pump, keep every refill appointment and know the emergency contact. A pump alarm, or a sudden return of severe spasticity, needs urgent attention.

Possible cautions and when to ask a pharmacist or doctor

Common effects are drowsiness, dizziness, weakness, nausea, dry mouth, confusion, low blood pressure and sometimes difficulty passing urine. Drowsiness and weakness are dose-related and usually improve as the dose is built slowly.

Get emergency help for:

Suspected withdrawal — high fever, marked confusion or agitation, hallucinations, seizures, or spasticity suddenly far worse than usual. This is life-threatening and needs immediate care. Say clearly that the person takes baclofen, and whether by pump.
Pump alarm or pump site problems — swelling, redness, pain or fluid leakage.
Marked drowsiness, difficulty waking, or slow or shallow breathing — possible overdose, more likely with kidney impairment.
Seizures.
Swelling of the face, lips or tongue, or difficulty breathing.

Contact your doctor if:

Spasticity is not controlled, or has increased. A sudden increase often has another cause — infection, constipation, a pressure sore, a blocked catheter, an ingrown toenail — and treating that frequently works better than raising the dose.
Weakness is interfering with walking, standing or transferring.
Confusion, mood changes or hallucinations develop, particularly in older people.
Kidney function changes, or you are started on a new medicine.
You are running low on tablets. Do not wait until the last one.

Related medicine guides

Frequently asked questions

What is baclofen 10 mg used for? Spasticity — muscle stiffness and spasm caused by multiple sclerosis, spinal cord injury, cerebral palsy or stroke. The 10 mg tablet is the usual starting strength.

Is it a painkiller? No. It relieves pain caused by muscle spasm by relaxing the spasm, but it has no direct pain-relieving action.

Can I take it for back pain or a pulled muscle? It is not intended for that. Baclofen treats spasticity of neurological origin; for ordinary muscle pain the drowsiness outweighs any benefit.

Is baclofen used for hiccups? Yes — for intractable hiccups lasting more than a couple of days, usually in seriously ill patients. It has better evidence than most alternatives. Ordinary hiccups need no treatment.

Can I stop taking it if it isn’t helping? Not suddenly. Abrupt withdrawal can cause a severe and potentially fatal reaction. Ask your doctor to plan a gradual reduction.

Why do I feel weaker on it? It reduces muscle tone, and some people rely on stiffness to stand or transfer. Tell your doctor — the dose can be adjusted to preserve useful function.

Can I drink alcohol on it? Best avoided. Both are sedating and the effects add together.

What is the intrathecal form? Baclofen delivered by an implanted pump directly into the spinal fluid, for severe spasticity not controlled by tablets. It uses a tiny fraction of the oral dose.

What Is Baclofen Used For?