GABA-B receptor agonist. Its beneficial effects in spasticity result from actions at spinal and supraspinal sites. Blocks mono-and-polysynaptic reflexes by acting as an inhibitory neurotransmitter, blocking the release of excitatory transmitters.


Spasticity: Start 5 mg orally three times daily, increase every 3 days to 20 mg orally three times daily. Max dose: 20 mg orally four times daily (80mg/day).
Hiccups (unlabeled use): 10-20 mg 2-3 times/day.


Injection (soln) intrathecal [preservative free] (Lioresal®):

50 mcg/mL (1 mL)

500 mcg/mL (20 mL)

2000 mcg/mL (5 mL).

Tablet: 10 mg, 20 mg



  • Test dose: 50-100 mcg, doses >50 mcg should be given in 25 mcg increments, separated by 24 hours.
  • A screening dose of 25 mcg may be considered in very small patients.
  • Patients not responding to screening dose of 100 mcg should not be considered for chronic infusion/implanted pump.
  • Maintenance: After positive response to test dose, a maintenance intrathecal infusion can be administered via an implanted intrathecal pump. Initial dose via pump: Infusion at a 24-hourly rate dosed at twice the test dose. Avoid abrupt discontinuation.