Baclofen dosage: safe starting doses, how to increase and what to watch for

Baclofen is a muscle relaxant used for spasticity and, in some cases, stubborn hiccups. Getting the dose right matters: too little won’t help, too much can cause heavy drowsiness, breathing problems, or worse. Below I’ll walk you through typical starting doses, how doctors usually increase the dose, common maintenance ranges, and simple safety tips you can use when you or a loved one takes baclofen.

Typical dosing and titration

For adults, most prescribers start low and increase slowly. A common starting plan is 5 mg three times a day (5 mg TID = 15 mg/day). After a few days, the dose is slowly raised by about 5–15 mg per day every 2–3 days, depending on how you feel and side effects. Typical maintenance doses fall in the 30–80 mg/day range, split into several doses (for example, 10 mg TID = 30 mg/day, 20 mg TID = 60 mg/day).

Many patients do well at 40 mg/day (for example, 10 mg morning, 10 mg midday, 20 mg evening). Some people may need higher doses, but going above 80 mg/day raises the risk of serious sedation and breathing issues and is usually done only under close medical supervision. There’s also an intrathecal option (baclofen pump) for severe spasticity; that uses much smaller amounts delivered into the spinal fluid and is managed by a specialist.

Children and elderly patients need adjusted dosing: children are dosed by weight, and older adults often start at lower doses and titrate more slowly. If you have kidney problems, your doctor will likely lower the dose because the drug is cleared by the kidneys.

Safety tips and warnings

Watch for drowsiness, dizziness, weakness, nausea, and headache—those are the common side effects. Avoid alcohol and be cautious with other sedatives (sleep medicines, strong painkillers) because combining them increases risk of heavy sedation and breathing trouble.

Do not stop baclofen suddenly. Abrupt withdrawal can cause agitation, hallucinations, high fever, seizures, or a big return of spasticity. If treatment should end, your doctor will taper the dose slowly over days to weeks.

If you’re being treated for hiccups, doctors may use similar starting doses but will tailor the plan to how quickly hiccups respond and to any side effects. Always follow the prescribing doctor’s instructions and ask about how quickly you can expect improvement and when to report problems.

Final practical tips: take baclofen with food if it upsets your stomach, split the total daily dose (don’t take it all at once), avoid driving until you know how it affects you, and keep regular follow-ups so the dose can be adjusted safely. When in doubt, call your prescriber—dosing should be personalized, and safety comes first.