Abrupt Discontinuation

• Abrupt discontinuation has resulted in high fever, altered mental status, exaggerated rebound spasticity, and muscle rigidity that in rare cases advances to rhabdomyolysis, multiple organ system failure and death.
• Careful attention to proper programming and monitoring of infusion system, refill schedules and procedures, and pump alarms to avoid abrupt withdrawal
• Patients and caregivers should be advised of the importance of keeping scheduled refill visits and should be
  educated on the early symptoms of baclofen withdrawal
• Special attention should be given to patients at apparent risk(e.g. spinal cord injuries at T-6 or above, communication difficulties, history of withdrawal symptoms from oral or intrathecal baclofen).
• Consult the technical manual of the implantable infusion system for additional post implant clinician and patient information.