Baclofen Tablets

Uses of Baclofen Tablets:

  • It is used to relax muscles.
  • It is used to treat spasms in patients with MS (multiple sclerosis) or spinal cord disease.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take Baclofen Tablets?

  • If you are allergic to this medicine (baclofen tablets); any part of this medicine (baclofen tablets); or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

This medicine may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine (baclofen tablets) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Baclofen Tablets?

  • Tell all of your health care providers that you take this medicine (baclofen tablets). This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this medicine (baclofen tablets) affects you.
  • Do not stop taking this medicine (baclofen tablets) all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this medicine (baclofen tablets), you will want to slowly stop it as ordered by your doctor.
  • Talk with your doctor before you drink alcohol or use other drugs and natural products that slow your actions.
  • Use with care in children. Talk with the doctor.
  • Taking this medicine (baclofen tablets) during pregnancy may lead to withdrawal in the newborn.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

How is this medicine (Baclofen Tablets) best taken?

Use this medicine (baclofen tablets) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • Take with or without food.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Very bad dizziness or passing out.
  • Feeling confused.
  • Change in how often urine is passed.
  • Mental, mood, or behavior changes that are new or worse.

What are some other side effects of Baclofen Tablets?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Feeling dizzy, sleepy, tired, or weak.
  • Trouble sleeping.
  • Upset stomach or throwing up.
  • Headache.
  • Constipation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Baclofen Tablets?

  • Store at room temperature in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer information use

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine (baclofen tablets), please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Baclofen use while Breastfeeding

Baclofen Levels and Effects while Breastfeeding

Summary of Use during Lactation

Limited information indicates that orally administered baclofen appears in low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Monitor newborn infants for signs of sedation. Low intrathecal doses and topical application produce even lower milk levels and are unlikely to affect the nursing infant.

Drug Levels

Maternal Levels. A woman with spastic paraplegia was given a single oral 20 mg dose of baclofen 14 days postpartum. A peak milk level of about 0.13 mg/L occurred 4 hours after the dose. The half-life in milk was 5.6 hours. The authors estimated that the total amount recovered in breastmilk over 26 hours was 22 mcg.

A woman with spinal cord injury was taking baclofen 20 mg four times at evenly spaced intervals between 0600 and 2200 daily during pregnancy and postpartum. Breast milk samples were collected at estimated trough (0530) and peak (2400) times on 3 consecutive days postpartum. Trough levels averaged 0.297 mg/L (range 0.28 to 0.32 mg/L). Peak levels averaged 0.343 mg/L (range 0.32 to 0.38 mg/L).[2] Using the average of the peaks and troughs, a fully breastfed infant would receive a daily dosage of 0.048 mg/kg, which would be 3.6% of the maternal weight adjusted dosage.

A woman with long-standing spasticity and flexion myopathy from a head injury was given continuous baclofen infusion via intrathecal pump during pregnancy and postpartum at a dose of 330 mcg daily. One postpartum sample of breastmilk was analyzed and found to contain 0.617 mcg/L of baclofen.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

An infant was born after exposure to baclofen in utero. The mother was taking baclofen 10 mg twice daily plus clonazepam 1 mg orally twice daily and sustained-release oxycodone 50 mg daily in divided doses. The infant was breast and bottle fed while the mother continued taking baclofen. Neonatal withdrawal symptoms necessitated phenobarbital administration. The infant also received baclofen 0.5 mg/kg daily in 4 divided doses that was weaned and decreased by day 9 of life. Neurologic examination was normal at discharge on day 16 and at 6-weeks of age.

A woman with spinal cord injury was taking baclofen 20 mg four daily during pregnancy and postpartum. After birth, the infant received an initial baclofen dosage of 0.1 mg/kg daily for 4 days, plus about 1/3 of the diet as breastmilk containing baclofen (about 0.016 mg/kg daily), followed by a daily decrease of 0.01 mg/kg daily until discontinuation of the baclofen on the 13th day of life. Breastmilk intake was eventually increased to 50% of the infant’s diet. Daily assessment for neonatal abstinence syndrome (NAS) was performed using the modified Finnegan NAS scoring system. Of 82 modified Finnegan NAS scores obtained in the first 16 days of life, the mean score was 2. The maximum NAS score of 9 was observed on the 13th day of life. At no point were there three consecutive NAS scores of 8 or greater, indicating no need for further pharmacological intervention. The infant was discharged 3 days after the taper ended.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.


Baclofen Pregnancy and Breastfeeding Warnings

Baclofen Pregnancy Warnings

This drug should be used during pregnancy only if the benefit outweighs the risk.

AU TGA pregnancy category: B3
US FDA pregnancy category: Not Assigned

This drug given orally in animal studies has been shown to increase the incidence of omphaloceles (ventral hernias) in fetuses at approximately 13 times on a mg/kg basis, or 3 times on a mg/m2 basis, the maximum oral dose recommended for humans; this dose also caused reductions in food intake and weight gain in the dams. There are no controlled data in human pregnancy. It is not known whether this drug can cause fetal harm or adversely affect reproductive capacity in humans.

AU TGA pregnancy category B3: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D and X are being phased out.

Baclofen Breastfeeding Warnings

Limited information indicates that this drug appears in low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Newborn infants should be monitored for signs of sedation.

Benefit should outweigh risk.

Excreted into human milk: Yes (in small amounts)

Drug Interactions with Baclofen

Medicines that interact with baclofen may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with baclofen. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with baclofen include:

  • anti-anxiety medications
  • anticonvulsants
  • antidepressants, such as amitriptyline, imipramine, nortriptyline, and monoamine oxidase inhibitors
  • antihistamines that cause sedation, such as diphenhydramine
  • opioid analgesics such as oxycodone and morphine
  • other muscle relaxants such as cyclobenzaprine
  • sleeping pills
  • some medications used to treat mental illness, such as clozapine and thioridazine.

Alcohol may worsen the side effects of baclofen such as drowsiness and dizziness.

Note that this list is not all-inclusive and includes only common medications that may interact with baclofen. You should refer to the prescribing information for baclofen for a complete list of interactions.

What is the disadvantages of taking Baclofen ?

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Drowsiness, dizziness, or sedation, which may affect your ability to drive or operate machinery or perform other hazardous tasks. The sedative effect of baclofen may be enhanced by alcohol or by other medications that also cause sedation (such as benzodiazepines, opiates).
  • Weakness, fatigue, insomnia, nausea, constipation, low blood pressure, headache, and confusion have also been reported.
  • Sudden discontinuation of baclofen has been associated with hallucinations and seizures. Baclofen should be withdrawn slowly unless it is an emergency.
  • May not be suitable for some people, including those with a history of stroke or who rely on spasticity to maintain an upright position, balance, or for increased function. The dosage of baclofen should be reduced in those with kidney disease.
  • People with a history of seizures or epilepsy should be monitored regularly for changes in seizure control or EEG recordings.
  • Neonatal withdrawal symptoms, such as increased muscle tone, tremor, jitteriness, or seizures have been reported starting hours to days after delivery in neonates whose mothers were treated with oral baclofen throughout pregnancy. If the potential benefit of using baclofen during pregnancy justifies the potential risk to the fetus then gradually reduce the dose and discontinue baclofen before delivery. Baclofen appears in low levels in milk but is not expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Monitor newborn infants for signs of sedation.
  • May cause an increase in the risk of ovarian cysts.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects.

What is the benefits of taking Baclofen ?

  • Baclofen is used to relieve muscle spasms such as those caused by multiple sclerosis or spinal cord injury due to damage or disease.
  • Particularly effective for relieving flexor spasms (involuntary muscle spasms involving the ankle, knee, or hip) and the pain, contractions, and rigidity associated with these.
  • May help restore some muscle function.
  • Baclofen is not effective for muscle spasms caused by rheumatoid arthritis, cerebral palsy, stroke or Parkinson’s disease.
  • May also be used off-label to treat other conditions such as hiccups or Tourette’s syndrome.
  • Generic baclofen is available.

Which Muscle Relaxants Are Best for Neck and Back Pain?

Whether from a new injury or an aggravated old injury, stiffness and soreness in the neck and back at night may lead to disrupted sleep and more pain in the morning. Muscle relaxants have been shown to help relieve this pain and get you through these tough days. Used at night, these medications may improve acute neck and back pain.

Your first-line treatment will still be over-the-counter pain relievers like acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve). They work better for neck and back pain than muscle relaxants, but there may be a benefit to taking them together, especially at night. Research shows that a muscle relaxant added to acetaminophen or an NSAID works better than either alone.

Now, let’s compare 9 popular muscle relaxants. How well do they work and what are their side effects? Oh, and are they affordable?

1) Methocarbamol

Methocarbamol (Robaxin) is a well-studied medication that treats back pain. It’s also inexpensive and relatively less sedating than other options. In recent studies where it was used for up to 8 days, 44% of folks that took methocarbamol had complete pain relief (compared to 18% who took nothing) — and that was without any serious side effects.

Taken as needed, 1500 mg every 6 to 8 hours is a cheap and well-tolerated option for sufferers of acute neck and back pain. Think of trying this first, as it is less sedating than other options, like cyclobenzaprine and carisoprodol.

2) Cyclobenzaprine

At the standard dose of 10 mg to 30 mg a day, cyclobenzaprine (Flexeril) will make you sleepy. If you use it during the day, you’ll want to break your 10 mg tab in half and take 5 mg to lessen the drowsiness. Interestingly, 5 mg three times a day has been shown in studies to work as well as 10 mg taken 3 times a day.

Cyclobenzaprine is a reasonable first choice because it’s a cheap generic, but the sedation side effect limits its use during the day. It may also cause more dry mouth, especially in older folks. If this is a concern, consider a better non-sedating option.

3) Carisoprodol

Carisoprodol (Soma) is a Schedule IV drug (similar to benzodiazepines Ativan, Valium, and Xanax) and has the potential for being abused. For this reason, you should not use it if you have a history of substance abuse.

Many believe that carisoprodol should be phased out as a muscle relaxant in favor of much better options. If prescribed, you should only use it for short periods of 2 to 3 weeks due to lack of evidence for effectiveness with longer use. It may cause drowsiness and dizziness, and it should not be used in folks over 65.

4) Metaxalone

Taken as 800 mg tablets 3 to 4 times a day, metaxalone (Skelaxin) has the fewest reported side effects and lowest sedation potential of the muscle relaxants based on clinical studies. Simply put, it is the best-tolerated of the muscle relaxants.

Metaxolone is a generic alternative for the brand drug Skelaxin, but it is still pricey. Insurance companies don’t like to cover it because there are cheaper alternatives. Having said that, it works as well as cyclobenzaprine and carisoprodol with fewer side effects and less sedation—so paying cash may be worth it.

5) Tizanidine

Tizanidine (Zanaflex) is often used for spasticity in patients with multiple sclerosis or cerebral palsy. Spasticity is where the muscles undergo continuous contraction, which leads to tightness and stiffness. In head-to-head studies with Baclofen for those conditions, tizanidine tends to have fewer side effects — but they both work just as well. This is not a first-line choice for acute neck or back muscle pain, though.

6) Baclofen

Similar to tizanidine, Baclofen is primarily used for spasticity in spinal cord injury patients or those with multiple sclerosis. Up to 20% of folks taking it have drowsiness, and there are better options for neck and back muscle pain. Also not a first choice.

7) Oxazepam and diazepam

Benzodiazepine medications like oxazepam and diazepam (Valium) are sometimes prescribed as muscle relaxants. However, these really aren’t recommended because they don’t work well, are sedating, and can be habit-forming. Avoid benzodiazepines for neck and back muscle pain because there are much better options.

8) Chlorzoxazone

Chlorzoxazone (Lorzone) is not well-studied for acute low back and neck pain in adults. And when investigated for pain after spine surgery, it wasn’t found to be effective. Chlorzoxazone has also been reported as a rare cause of acute liver toxicity. Don’t choose this until you’ve exhausted all other options.

9) Orphenadrine

For neck and back pain in adults, the first 4 medications on this list work better than orphenadrine (Norflex), so save this as another last resort in the event the others don’t work. It just hasn’t been well studied for this purpose.

What is the difference between Baclofen and Cyclobenzaprine for Muscle Spasms ?

Many people experience muscle cramps (spasms) every now and then. Muscle spasms typically occur when we overuse or injure our muscles. While these cramps can be painful, they usually last for only a few seconds or minutes.

But for some people, muscle spasms are frequent and intensely painful. The spasms can also last for long periods of time. When a spasm hits, severe symptoms can negatively impact your quality of life.

Fortunately, medications are available that can help relieve your symptoms. Two common muscle relaxer medications are baclofen and cyclobenzaprine (Flexeril). They’re routinely filled at pharmacies across the country with a similar treatment goal in mind, but they’re given for different reasons.

Here, we’ll compare baclofen and cyclobenzaprine — what they are, how effective they are, and what side effects to expect.

What is baclofen?

Baclofen is a prescription medication that’s usually taken by mouth. It can also be given as a spinal injection (Gablofen).

Baclofen is considered to be an antispastic muscle relaxant or a spasmolytic, which is used to treat muscle spasms due to brain injury or nerve damage.

What is baclofen approved to treat?

Antispastic muscle relaxants — like baclofen — are used for muscle spasticity conditions. For these conditions, people have unusually tight, stiff, and rigid muscles that repeatedly spasm because of brain injury or nerve damage.

In fact, the FDA approved baclofen to treat muscle spasticity symptoms caused by spinal injuries or spine-related medical conditions. The FDA also approved baclofen to relieve similar symptoms in people with multiple sclerosis (MS), a type of autoimmune disorder.

How does baclofen work for muscle spasms?

Baclofen is thought to work by affecting the spinal nerves. It lessens the number and severity of muscle spasms. It also relieves pain, loosens rigid muscles, and helps with muscle movement.

What is cyclobenzaprine?

Like baclofen, cyclobenzaprine is a prescription medication that’s taken by mouth. But unlike baclofen, cyclobenzaprine is an antispasmodic muscle relaxant. This means it’s used to treat muscle spasms due to muscle and bone problems.

What is cyclobenzaprine approved to treat?

Cyclobenzaprine is routinely used to treat muscle spasms caused by musculoskeletal conditions. These are muscle spasms related to problems from the muscles and bones — not the brain or spine.

These types of muscle spasms can also be painful. But the pain is usually acute (short-term), not chronic. So, the FDA only approved cyclobenzaprine use for 2 to 3 weeks at a time to relieve painful muscle spasms from these musculoskeletal conditions. Cyclobenzaprine should also be used in combination with rest and physical therapy when possible.

How does cyclobenzaprine work for muscle spasms?

Cyclobenzaprine is thought to relax muscles by mainly working in the brain. To a lesser extent, it also exerts its effects on the spine. It doesn’t work by affecting muscles directly.

How are baclofen and cyclobenzaprine dosed and given?

The following table contains information on how baclofen and cyclobenzaprine oral tablets are dosed and given.

Baclofen Cyclobenzaprine
Tablet strengths 5 mg
10 mg
20 mg
5 mg
7.5 mg
10 mg
Typical starting dose 5 mg by mouth 3 times daily 5 mg by mouth 3 times daily
Usual maximum daily dose 20 mg by mouth 4 times daily 10 mg by mouth 3 times daily
Duration of Use 1-2 months, or until you and your healthcare provider decide to slowly stop the medication 2-3 weeks
Kidney or liver function affects dosing Yes, kidney Yes, liver

As a reminder, baclofen is also given as an injection into the back. It’s also available as an oral (by mouth) liquid. Cyclobenzaprine is also available as an oral capsule. If you have any questions about how these other dosage forms are used, talk with your pharmacist or healthcare provider.

How effective are baclofen and cyclobenzaprine for treating muscle spasms?

For muscle spasticity conditions — especially spinal injuries — experts consider baclofen as a possible first-choice option. Clinical trials showed that baclofen improved muscle tone in up to 72% of study participants.

For muscle spasms caused by muscle and bone issues, cyclobenzaprine is considered moderately effective. Studies have suggested that people taking cyclobenzaprine are 5 times more likely than placebo (a pill with no medication in it) to experience improvement in pain-related muscle symptoms.

What are the known side effects of baclofen and cyclobenzaprine?

Like all medications, both baclofen and cyclobenzaprine have a number of side effects. Some are common to both medications, and some are more unique to just one. Side effects can also vary by dose and dosage form (pill, injection, etc).

The following are some common side effects for common doses of baclofen and cyclobenzaprine:

Side effect Baclofen Cyclobenzaprine
Drowsiness 10-63% 29%
Dry mouth Rare 21%
Dizziness 5-15% 1-3%
Weakness 5-15% Less than 1%
Headache 4-8% 5%

What are the serious side effects of baclofen?

A number of rare but serious side effects are also possible. If you experience serious side effects with baclofen, such as the ones below, get medical help right away.

Sudden discontinuation (withdrawal) symptoms

Abruptly stopping baclofen can cause severe withdrawal symptoms, which can include seizures, unusual behavior, and more.

If you would like to stop using baclofen, talk with your healthcare provider first. They can help you slowly stop the medication to prevent withdrawal side effects.

Withdrawal symptoms in newborn babies

If you’re taking baclofen throughout your pregnancy, your healthcare provider may want to slowly stop this medication before your delivery date to limit withdrawal side effects in your baby. This is because within hours to days after delivery, newborn babies can experience withdrawal symptoms, such as rigid muscles, tremors, and seizures.


In people with epilepsy, baclofen can raise the odds of having seizures. Your healthcare provider may want to closely monitor your brain waves over time to keep your seizure risk in check.

What are the serious side effects of cyclobenzaprine?

For cyclobenzaprine, seek immediate medical attention if you have symptoms like serotonin syndrome, heart-related side effects, or other similar symptoms.

Serotonin syndrome

Serotonin syndrome is a rare but potentially life-threatening condition. Symptoms of serotonin syndrome may include confusion, sweating, seizures, and tremors. Risk of serotonin syndrome is higher when you take cyclobenzaprine with other medications that raise serotonin levels. Serotonin is a naturally-occurring chemical in the body.

Heart-related side effects

Cyclobenzaprine might raise your risk for heart-related side effects, including a fast heartbeat and abnormal heart rhythm.

What interactions do baclofen and cyclobenzaprine have?

In general, don’t take baclofen or cyclobenzaprine with alcohol, opioid medications, or benzodiazepines. These can worsen side effects of your medication, like drowsiness or sleepiness.

You should also avoid taking cyclobenzaprine within 14 days of taking a monoamine oxidase inhibitor (MAOI). Combining cyclobenzaprine and MAOIs drastically raises your risk of serotonin syndrome. Examples of MAOIs include linezolid (Zyvox) and selegiline (Emsam).

Additionally, when taking cyclobenzaprine, use caution with tramadol (Ultram). Combining these two medications can worsen your seizure risk.

This is not a complete list of drug interactions for baclofen and cyclobenzaprine. For more detailed information about medication interactions for each muscle relaxant, talk with your pharmacist or healthcare provider.

6 Baclofen Interactions You Should Watch Out for

Like most medications, baclofen has drug interactions to be aware of. Interactions can occur with other medications and substances that have similar effects on the body. This includes sleepiness, dizziness, and weakness. In rare instances, this can lead to severe side effects like difficulty breathing.

Below we’ll discuss a few medications and substances that can interact with baclofen. But this isn’t a complete list. Talk to your healthcare provider and pharmacist before starting baclofen. Provide them with an updated list of all your medications. They can help you check for possible baclofen interactions.

1. Alcohol

Muscle relaxers, like baclofen, may interact with alcohol. Drinking alcohol while taking baclofen can cause weakness, dizziness, and confusion.

Baclofen and alcohol impact the central nervous system (CNS). The CNS consists of your brain and spinal cord. Medications and substances that lower the activity of the CNS can cause symptoms:

  • Lowered concentration
  • Confusion
  • Headache
  • Dizziness
  • Slowed speech
  • Problems with coordination
  • Worsening memory
  • Lower blood pressure
  • Slowed breathing

When alcohol and baclofen are combined, these side effects are more likely. If you drink alcohol, talk with your healthcare provider before starting baclofen. They can provide guidance on how much alcohol, if any, is safe to drink with your medication.

2. Opioids

Opioids are a class of medications that are usually used to treat moderate to severe pain. Examples of opioids include oxycodone (Oxycontin, Roxicodone), morphine (MS Contin, Kadian), and tramadol (Ultram).

Individually, opioids and baclofen can both cause your brain to slow down. In 2016, the FDA warned about the risk of combining opioids with other medications that affect the brain. This includes baclofen. They warned that a combination of these medications can cause serious side effects. Slowed and ineffective breathing is possible, and can lead to death in severe cases.

If you take opioids, it’s a good idea to have Narcan (naloxone) on hand at all times. This is especially important if you’re taking opioids with a medication that amplifies opioid effects. You can get Narcan without a prescription at your local pharmacy in every state. And in some states, you can get Narcan for free.

Before starting baclofen, make sure to tell your healthcare provider if you’re taking opioids. They may recommend you slowly lower your opioid dose if baclofen is needed. Or they may recommend another medication besides baclofen. It’s important to note that the prescribing information for intrathecal baclofen has a specific warning about epidural morphine. Epidural morphine is administered into the spine. Combining these two products can cause difficulty breathing and low blood pressure.

3. Benzodiazepines

Benzodiazepines (BZDs) are a group of medications that treat many health conditions, including anxiety, panic disorder, and more. A few examples of medications in this class include alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan).

Like opioids, BZDs can slow down your brain, and cause similar side effects as those caused by baclofen. This can lead to more serious symptoms such as slow and shallow breathing, and even death.

If you take BZDs, talk with your healthcare provider before starting baclofen. They may recommend stopping your BZD or adjusting the dose. Or they may recommend avoiding baclofen. But, don’t make any changes to your medications without talking to your healthcare provider. Stopping medications like BZDs abruptly can be dangerous.

4. Sleep medications

Sleep medications — like zolpidem (Ambien) and doxylamine (Unisom Sleep Tabs) — can cause excessive sleepiness when taken with baclofen. Medications that aren’t approved for sleep (but cause sleepiness as a side effect) can also interact with baclofen. This includes trazodone, diphenhydramine (Benadryl), and gabapentin (Neurontin).

Excessive sleepiness can lead to trouble with coordination. It can also impact your ability to complete daily tasks. If you take sleep medication, let your healthcare provider know before starting baclofen. They may recommend you avoid one of these medications entirely.

If you need baclofen and a sleep medication, avoid activities that require you to be alert until you know how the combination affects you. That includes driving and operating heavy machinery.

5. Barbiturates

Barbiturates are a group of medications that treat seizures and sleep problems. Examples include phenobarbital and pentobarbital. Pentobarbital is only used in hospitals because it’s given through a vein.

Barbiturates slow down brain activity and can cause drowsiness on their own (which is what they’re often used for). When combined with baclofen, the risk for severe drowsiness is higher.

If you need a barbiturate, your healthcare provider may recommend stopping baclofen slowly. Or, they may ask you to monitor closely for side effects. These include extreme sleepiness, confusion, or trouble breathing.

6. Other muscle relaxers

There are multiple other muscle relaxers available besides Baclofen. Examples include methocarbamol, cyclobenzaprine (Fexmid, Amrix), and tizanidine (Zanaflex). While these medications don’t all necessarily work just like baclofen, they have a similar effect of muscle relaxation. They can also cause dizziness and drowsiness. When combined with baclofen, these effects can be amplified.

In general, it’s best to avoid taking multiple muscle relaxers at once. If you’re taking baclofen and not feeling relief, talk to your healthcare provider. They may recommend an alternative option.