| アブストラクト | OBJECTIVE: This review highlights adverse effects of baclofen and tizanidine in older community-dwelling adults. DATA SOURCES: A literature search was conducted, including search terms of "adverse effect," "baclofen," "elderly," "falls," "fractures," and "tizanidine." Studies were included if they described community-dwelling adults aged 50 years and older who received oral baclofen or tizanidine. The Federal Drug Administration Adverse Event Reporting System (FAERS) data were compiled for adverse effect incidence. STUDY SELECTION AND DATA EXTRACTION: The literature search was completed in July 2019 and updated in June 2023. Reviews performed by 2 independent reviewers yielded 15 records. FAERS identified 486 (baclofen) and 305 (tizanidine) adverse effects of interest. DATA SYNTHESIS: Two retrospective cohort studies evaluating baclofen use in older adults showed increased hospitalizations for encephalopathy in chronic kidney disease (7.2% vs 0.1%) and end-stage renal disease (daily dose 20 mg or more; relative risk [RR] 19.8, 95% CI = [14.0-28.0]). Other articles were case reports; 10 articles reported dyskinesias, encephalopathy or disorientation, and drowsiness associated with baclofen, and 5 articles reported bradycardia and/or hypotension with tizanidine. The FAERS Public Dashboard revealed 12.1% and 28.7% overall incidence of adverse effects of interest, with a 27.8% and 29.2% incidence of falls for baclofen and tizanidine, respectively. Baclofen and tizanidine are associated with concerning adverse effects in older adults. Alternative agents should be considered, but, if necessary, providers should start at lower doses and increase slowly. CONCLUSIONS: This review highlights the importance of using baclofen and tizanidine with caution in older adults. |
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| ジャーナル名 | The Annals of pharmacotherapy |
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| Pubmed追加日 | 2023/8/17 |
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| 投稿者 | Killam-Worrall, Lisa; Brand, Romana; Castro, Janine R; Patel, Dipa S; Huynh, Katherine; Lindley, Bryn; Torres, Brittany Palasik |
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| 組織名 | Department of Pharmacotherapy, College of Pharmacy, University of North Texas;Health Sciences Center, Fort Worth, TX, USA.;Wise Regional Health System Emergency Department, Decatur, TX, USA.;Clinical Operations, Medpace, Garland, TX, USA.;CVS Pharmacy, Fort Worth, TX, USA.;Liberty Software, Grapevine, TX, USA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37589096/ |
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