Baclofen may also lower the seizure threshold, so caution must be taken in treating patients with epilepsy. Pharmacists have an important role and responsibility to their patients in detecting and preventing adverse effects. Pharmacists will be involved in the supply of medicines for often complex regimes, and may be able assist in identifying the cause of adverse effects. They may be able to advise on alternative treatment if adverse effects are problematic. It may be beneficial to titrate doses more slowly in elderly patients in order to minimise troublesome adverse effects and maximise the chances of achieving a therapeutic dose.
Pharmacists are able to identify interactions with drugs used for spasticity.
Care should be taken when antispastic drugs are used in combination with other CNS depressants because drowsiness and sedation may be enhanced. This increases the risk of baclofen toxicity, which presents as confusion, bradycardia, disorientation, and blurred vision. Patients with spasticity may seek the advice of the pharmacist in the treatment of concomitant problems such as constipation. Their condition may also demand the use of an appropriate formulation. For example, a patient with MS living alone may be unable to open blisters.