Lyvispah (Baclofen) - Oral

What Is Lyvispah?

Lyvispah (baclofen) is a skeletal muscle relaxant used to relax or loosen muscle tightness related to multiple sclerosis or other spinal cord problems.

Lyvispah is categorized as a skeletal muscle relaxant that prevents the signaling of nerve reflexes in the spinal cord by binding to receptors called GABA-B. As a result, the movement of the muscles decreases.

You can get baclofen by prescription only. It is available as a tablet that you can take by mouth or an injection to be given intrathecally (injection into the spinal canal). This article will focus on the oral formulation and not the injection.

Drug Facts

Generic Name:  Baclofen

Brand Name(s): Lyvispah, Fleqsuvy, Ozobax

Drug Availability: Prescription

Therapeutic Classification: Skeletal Muscle Relaxant

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Oral (by mouth)

Active Ingredient: Naclofen

Dosage Form(s): Packet (granules), solution, suspension, tablet

What Is Lyvispah Used For?

The Food and Drug Administration (FDA) approved Lyvispah to treat muscle spasms related to multiple sclerosis or spinal cord problems. It helps to relieve flexor spasms, which occur when the leg and hip muscles become so tight that the limbs become locked in a bent position and difficult to straighten. Lyvispah can also help with the associated pain, clonus (involuntary, rhythmic muscle contractions), and muscular rigidity.

Lyvispah (Baclofen) Drug Information: A person with some back muscles showing and some spinal chord nerves

Verywell / Dennis Madamba

How to Take Lyvispah

As always, you should take baclofen as instructed by your healthcare provider and follow their directions as stated.

Lyvispah comes as oral granules in a packet. Typically, dosing can range from 5 to 20 milligrams (mg) per packet. Initially, you will take Lyvispah three times a day by mouth. Your healthcare provider may increase your dosage as needed, usually by 5 milligrams while continuing at three times daily. You should not take more than 80 milligrams (the maximum dosage) per day.

The following are tips for taking the oral granules

  • Empty the entire contents of the packet into your mouth. Let the granules dissolve or swallow them.
  • If needed, you can take the granules with liquid or soft foods. Take one packet with up to 15 milliliters (mL) of liquid or soft foods (e.g., applesauce, yogurt, or pudding). Don't take the mixture more than two hours after mixing.
  • If you are mixing more than one packet, mix each packet separately with liquid or soft food.

Additionally, Lyvispah can be given through feeding tubes.

Oral baclofen is also available as a solution (under the brand name Ozobax), suspension (under the brand name Fleqsuvy), and tablet (generic only).

Avoid drinking alcohol while taking baclofen as alcohol is a depressant that can cause worsening adverse effects. 

Storage

Store Lyvispah at room temperature (between 68 and 77 degrees F) and away from moisture. Storing your medication in hot and cold areas can prevent the medication from working correctly. As always, make sure your medication is stored in a safe place where children and pets cannot reach it.

If you need more of your medication, contact your pharmacy or prescribing healthcare provider to request a refill.

Off-Label Uses

A healthcare provider may prescribe off-label treatments when the decision is supported by scientific evidence or expert clinical experience.

Baclofen has been studied for the following off-label uses:

Despite these indications not being approved by the FDA, there have been clinical studies showing baclofen's effectiveness and safety.

How Long Does Lyvispah Take to Work?

After taking the first dose of oral baclofen, it can take 45 minutes to two hours to reach peak effect in the body. However, it may take two to four days to fully relieve your tight muscles.

What Are the Side Effects of Lyvispah?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The side effects commonly reported with baclofen include:

  • Feeling tired
  • Nausea
  • Headache
  • Constipation
  • Weakness

Severe Side Effects

Do not hesitate to contact your healthcare provider right away if you are experiencing any of these rare but severe side effects. Call 911 immediately if your symptoms feel life-threatening or you think you need medical assistance.

Rare but severe side effects associated with baclofen include:

  • Fainting or passing out
  • Confusion
  • Seizures
  • Balance or posture changes
  • Depression
  • High blood pressure
  • Ovarian cysts
  • Increased seizures in people with epilepsy

It is important to continue taking baclofen until your healthcare provider tells you to stop. Suddenly stopping this medication can worsen your symptoms or cause the following side effects:

  • Increased muscle stiffness
  • Itching
  • Tingling in hands and feet
  • Seizures
  • Hallucinations
  • Confusion
  • High blood pressure
  • High fever

Report Side Effects

Lyvispah may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Lyvispah Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For muscle relaxation:
    • For oral dosage form (granules):
      • Adults and children 12 years of age and older—At first, 5 milligrams (mg) 3 times a day for 3 days. Your doctor may increase your dose by 5 mg every 3 days as needed and tolerated. However, the dose is usually not more than 80 milligrams (mg) per day (20 mg four times a day).
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (solution):
      • Adults and children 12 years of age and older—At first, 5 milliliters (mL) 3 times a day for 3 days. Your doctor may increase your dose by 5 mL every 3 days as needed and tolerated. However, the dose is usually not more than 80 milligrams (mg) per day (20 mg four times a day).
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults and teenagers—At first, 5 milligrams (mg) 3 times a day. Your doctor may increase your dose by 5 mg every 3 days until the desired response is reached. However, the dose is not more than 80 mg per day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Oral baclofen is available in the following formulations:

  • Granule (Lyvispah)
  • Solution (Ozobax)
  • Suspension (Fleqsuvy)
  • Tablet (generic only)

Initially, the dosage for baclofen for children ranges between 10 to 80 milligrams daily, depending on the child’s age. If your child has difficulty swallowing medication, you can talk to their healthcare provider about either using the liquid formulation or mixing the granules with liquid or soft food (e.g., yogurt, pudding, or applesauce). You can crush the tablet and mix it with no more than 1 tablespoon of food.

Baclofen can also be administered through a feeding tube.

Before starting baclofen, talk to your healthcare provider if you:

  • Are pregnant: Withdrawal symptoms have been reported in infants born to pregnant people treated with baclofen.
  • Are breastfeeding or plan to breastfeed: Baclofen can pass through human breast milk.
  • Have poor kidney function: Notifying your healthcare provider about your kidney function will allow them to adjust the dosage to your needs.

It would help if you also told your healthcare provider about other health conditions so that they can monitor your treatment with baclofen accordingly.

Missed Dose

If you happen to miss a dose, don't panic. Take the missed dose as soon as you remember. Do not take more than prescribed at one time to make up for the missed dose, as this can increase the chances of unwanted side effects.

Overdose: What Happens If I Take Too Much Lyvispah?

The results of a published study determined that the average amount of baclofen leading to an overdose was about 200 milligrams or greater. People who were admitted to the hospital after taking more than the recommended dosage experienced the following symptoms:

  • Seizures 
  • Loss of consciousness
  • Mental confusion
  • Slow breathing rate
  • Coma

Taking excess Lyvispah, whether intentionally or accidentally, can lead to severe side effects and even death.

What Happens If I Overdose on Lyvispah?

If you think you or someone else may have overdosed on Lyvispah, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Lyvispah, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Do not suddenly stop using this medicine without checking first with your doctor. You may need to slowly decrease your dose before stopping it completely. Unwanted side effects (eg, hallucinations, seizures, high fever, rhabdomyolysis) may occur if baclofen is stopped suddenly.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, other muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using baclofen.

This medicine may cause dizziness, drowsiness, vision problems, or clumsiness or unsteadiness in some people. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert, well-coordinated, and able to see well.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has shakiness or tremors, seizures, or increased muscle tone.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Lyvispah?

You should not take Lyvispah:

  • To treat muscle spasms related to joint problems
  • If you have been diagnosed with cerebral palsy, Parkinson's disease, or a stroke
  • If you have had a previous allergic reaction to baclofen

What Other Medications Interact With Lyvispah?

When taking Lyvispah, you must be aware of medications or supplements that can make your side effects worse or reduce how well the drug works.

Avoid taking any baclofen product with central nervous system (CNS) depressant medications. Baclofen and CNS depressants both decrease the activity of the nervous system. Therefore, taking both at the same time can slow breathing and lead to unresponsiveness or severely low blood pressure.

Common CNS depressants include:

What Medications Are Similar?

Other than baclofen, other medications that can be used to treat muscle spasms related to spinal injuries include:

Zanaflex

Tizanidine, or Zanaflex, is an effective and safe treatment for muscle spasms related to the spinal cord. Tizanidine activates receptors in your brain that prevent the release of chemicals that cause muscle movement. As a result, muscle contraction decreases. With regard to efficacy and safety, there is no significant difference between baclofen and tizanidine. Tizanidine may be the second drug of choice if you have trouble tolerating baclofen.

Flexeril

Like baclofen, cyclobenzaprine (available under the brand name Flexeril) is also considered a skeletal muscle relaxant. However, Flexeril treats muscle spasms related to muscle and bone issues, not the spine. Lyvispah is preferred as the first line of treatment for muscle spasms over Flexeril, especially for nerve injuries.

Skelaxin

Skelaxin (metaxalone) is a prescription medication that relieves symptoms from acute, painful musculoskeletal conditions. Although both metaxalone and baclofen are muscle relaxers, metaxalone is typically used short-term, whereas baclofen is used for people dealing with chronic muscle spasticity problems.

Chlorzoxazone

Chlorzoxazone, like metaxalone, is a muscle relaxant used to treat painful musculoskeletal conditions.

This list is a list of drugs belonging to the same therapeutic class as Lyvispah. It is NOT a list of drugs recommended to take with Lyvispah. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • How long does it take for baclofen to help with my muscle spasms?

    It can take about 45 minutes to two hours after taking Lyvispah to feel any effects.

  • Can baclofen treat back pain?

    Baclofen is not designed to treat back pain. While Lyvispah reduces the pain due to muscle spasms, it does not help with pain related to inflammation. 

  • Is it OK to split the pill before taking it?

    Yes, if you are prescribed the tablet form of baclofen, you may break up the tablet before taking it. Sometimes, you can save money by requesting a 10-milligram dose tablet and splitting the tablet in half for your 5-milligram dose. Make sure your medication list is up to date with the right dose.

How Can I Stay Healthy While Taking Lyvispah?

To stay healthy while taking baclofen, it is important to take this medication as instructed by your healthcare provider. Do not stop taking the medication even if you feel better unless you are told to do so by your healthcare provider.

Try to avoid strenuous activities or lifting heavy objects during treatment. If your job requires you to do so, don't hesitate to inform your manager about your condition. Straining your muscles may slow your progress to feeling better. Your healthcare provider can let you know what level of activity and lifestyle change would be right for you.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Acknowledgement

The author would like to recognize and thank Alexya Rosas for contributing to this article.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Lyvispah (baclofen) label.

  2. National Multiple Sclerosis Society. Spasticity.

  3. Puri N, Rathore A, Dharmdeep G, et al. A clinical study on comparative evaluation of the effectiveness of carbamazepine and combination of carbamazepine with baclofen or capsaicin in the management of trigeminal neuralgia. Niger J Surg. 2018;24(2):95-99. doi:10.4103/njs.NJS_8_18

  4. de Beaurepaire R, Sinclair JMA, Heydtmann M, et al. The use of baclofen as a treatment for alcohol use disorder: a clinical practice perspective. Front Psychiatry. 2019;9:708. doi:10.3389/fpsyt.2018.00708

  5. Romito JW, Turner ER, Rosener JA, et al. Baclofen therapeutics, toxicity, and withdrawal: a narrative review. SAGE Open Medicine. 2021. doi:10.1177/20503121211022197

  6. MedlinePlus. Baclofen.

  7. Leung NY, Whyte IM, Isbister GK. Baclofen overdose: defining the spectrum of toxicity. Emerg Med Asutralas. 2006;18(1):77-82. doi: 10.1111/j.1742-6723.2006.00805.x

  8. Food and Drug Administration. Zanaflex label.

  9. Ertzgaard P, Campo C, Calabrese A. Efficacy and safety of oral baclofen in the management of spasticity: a rationale for intrathecal baclofen. J Rehabil Med. 2017;49(3):193-203. doi:10.2340/16501977-2211

  10. Witenko C, Moorman-Li R, Motycka C, et al. Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. P T. 2014;39(6):427-435. 

  11. Food and Drug Administration. Skelaxin- metaxalone tablet.

  12. DailyMed. Lablet- Chlorzoxazone tablet.