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Drug Safety-related Labeling Changes (SrLC)

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LIORESAL (NDA-020075)

(BACLOFEN)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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01/16/2019 (SUPPL-37)

Approved Drug Label (PDF)

5 Warnings and Precautions

WARNINGS

(Additions and/or revisions are underlined)

Overinfusion: Delivery of more drug volume than the programmed rate (overinfusion) can result in unexpected overdose, or withdrawal caused by early emptying of the pump reservoir. Refer to the manufacturer's pump manual and instructions for refilling the reservoir.

09/30/2016 (SUPPL-32)

Approved Drug Label (PDF)

5 Warnings and Precautions

PRECAUTIONS (addition underlined)

Precautions in special patient populations:… No increase in tumors was seen in rats receiving baclofen orally for two years. Adequate genotoxicity assays of baclofen have not been performed.

 

PREGNANCY

There are no adequate and well-controlled studies in pregnant women. In animal studies, baclofen had adverse effects on embryofetal development when administered orally to pregnant rats. LIORESAL INTRATHECAL should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

 

Baclofen given orally increased the incidence of fetal structural abnormalities (omphaloceles) in rats. Reductions in food intake and body weight gain were observed in the dams. Fetal structural abnormalities were not observed in mice or rabbits.

WARNINGS (addition underlined)

Withdrawal:…All patients receiving intrathecal baclofen therapy are potentially at risk for withdrawal. Early symptoms of baclofen withdrawal may include return of baseline spasticity, pruritus, hypotension, and paresthesias.  Priapism may develop or recur if treatment with intrathecal baclofen is interrupted.

6 Adverse Reactions

(addition underlined)


Spasticity of Spinal Cord Origin – Clinical Studies:

 

Commonly Observed in Patients with Spasticity of Spinal Origin — In pre- and post- marketing clinical trials, the most commonly observed adverse events associated with use of LIORESAL

 

INTRATHECAL (baclofen injection) which were not seen at an equivalent incidence among placebo- treated patients were: somnolence, dizziness, nausea, hypotension, headache, convulsions and hypotonia.


Associated with Discontinuation of Treatment — 8/474 patients with spasticity of spinal cord origin

receiving long term infusion of LIORESAL INTRATHECAL in pre- and post- marketing clinical studies in the U. S. discontinued treatment due to adverse events. These include: pump pocket infections (3), meningitis (2), wound dehiscence (1), gynecological fibroids (1) and pump overpressurization (1) with unknown, if any, sequela. Eleven patients who developed coma secondary to overdose had their treatment temporarily suspended, but all were subsequently re-started and were not, therefore, considered to be true discontinuations.

Postmarketing Experience: (subsection added)

The following adverse events have been reported during post-approval use of LIORESAL INTRATHECAL. Because these events are reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency.

 

Musculoskeletal: The onset of scoliosis or worsening of a pre-existing scoliosis has been reported. Urogenital: Sexual dysfunction in men and women, including decreased libido and orgasm dysfunction, have been reported. Erectile dysfunction in men has also been reported. Priapism has been reported following baclofen withdrawal.