Baclofen with Remifentanil Interaction Details
Brand Names Associated with Baclofen
- Baclofen
- Kemstro®
- Lioresal®
- Ozobax®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 04, 2024
Interaction Effect
Increased risk of CNS depression (ie, respiratory depression, profound sedation, coma)
Interaction Summary
When remifentanil is used as postoperative analgesia, concomitant use with CNS depressants can lead to hypotension, sedation, respiratory depression, coma, and death. If concomitant use is required, administer the lowest effective dose of each agent for the shortest duration necessary and monitor for signs of respiratory depression[1].
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
When remifentanil is used as postoperative analgesia, concomitant use with CNS depressants can lead to hypotension, sedation, respiratory depression, coma, and death. If concomitant use is required, administer the lowest effective dose of each agent for the shortest duration necessary and monitor for signs of respiratory depression[1].
Mechanism Of Interaction
Additive CNS depression
Literature Reports
A) In a cohort study of data from 2004 to 2009, the risk of fatal overdose significantly increased by 2.33 fold in patients taking opioid analgesics with a history of a benzodiazepine prescription and increased by 3.86 fold in those with a current benzodiazepine prescription compared with those taking opioid analgesics without a history of a benzodiazepine prescription. The risk of drug overdose deaths increased with increasing daily doses of benzodiazepines [2].
References
1 ) Product Information: ULTIVA(R) intravenous injection, remifentanil HCl intravenous injection. Mylan Institutional LLC (per FDA), Rockford, IL, 2016.
2 ) US Food and Drug Administration (FDA): Drug Safety Communications: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. US Food and Drug Administration (FDA). Silver Spring, MD. 2016. Available from URL: http://www.fda.go... . As accessed 2016-08-31.
Baclofen Overview
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Baclofen is used to treat pain and certain types of spasticity (muscle stiffness and tightness) from multiple sclerosis, spinal cord injuries, or other spinal cord diseases. Baclofen is in a class of medications called skeletal muscle relaxants. Baclofen acts on the spinal cord nerves and decreases the number and severity of muscle spasms caused by multiple sclerosis or spinal cord conditions. It also relieves pain and improves muscle movement.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.