Indications And Dose
Pain of muscle spasm in palliative care ▶BY MOUTH ▶Adult: 5–10 mg 3 times a day Hiccup due to gastric distension in palliative care ▶BY MOUTH ▶Adult: 5 mg twice daily Chronic severe spasticity resulting from disorders such as multiple sclerosis or traumatic partial section of spinal cord ▶BY MOUTH ▶Adult: Initially 5 mg 3 times a day, gradually increased; maintenance up to 60 mg daily in divided doses, review treatment if no benefit within 6 weeks of achieving maximum dose; maximum 100 mg per day Severe chronic spasticity unresponsive to oral antispastic drugs (or where side-effects of oral therapy unacceptable) or as alternative to ablative neurosurgical procedures (specialist use only) ▶BY INTRATHECAL INJECTION ▶Adult: Test dose 25–50 micrograms, to be given over at least 1 minute via catheter or lumbar puncture, then increased in steps of 25 micrograms (max. per dose 100 micrograms), not given more often than every 24 hours to determine appropriate dose, then dose- titration phase, most often using infusion pump (implanted into chest wall or abdominal wall tissues) to establish maintenance dose (ranging from 12 micrograms to 2 mg daily for spasticity of spinal origin or 22 micrograms to 1.4 mg daily for spasticity of cerebral origin) retaining some spasticity to avoid sensation of paralysis
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