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Baclofen toxicity associated with declining renal clearance after ibuprofen
Drug Intelligence & Clinical Pharmacy
|October 1, 1984
Summary
Ibuprofen can cause kidney problems, reducing baclofen clearance and leading to toxicity in patients with spinal cord injuries. Close monitoring of baclofen is crucial when kidney function declines.
Area of Science:
- Pharmacology
- Nephrology
- Neurology
Background:
- Baclofen is a muscle relaxant commonly used for spasticity.
- Spinal cord injury patients may have altered drug metabolism and excretion.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can affect renal function.
Observation:
- A 64-year-old male with incomplete spinal cord injury developed baclofen toxicity.
- The patient was taking baclofen and initiated ibuprofen therapy.
- Significant increases in blood urea nitrogen and serum creatinine were observed after ibuprofen initiation.
Findings:
- The patient exhibited symptoms of baclofen toxicity, including confusion, bradycardia, and hypothermia.
- Ibuprofen-induced renal insufficiency reduced baclofen clearance.
- Discontinuation of ibuprofen and baclofen tapering reversed the toxicity and corrected renal indices.
Implications:
- Patients on baclofen require close renal function monitoring, especially when initiating ibuprofen.
- Clinicians must be aware of the potential for drug interactions between ibuprofen and baclofen.
- This case highlights the importance of considering renal function in baclofen pharmacokinetics and toxicity.