You and your caregivers will have important responsibilities throughout your treatment with a baclofen pump. You can help make your treatment effective and safe for you.
It is very important to keep all of your refill appointments so that you do not run out of medication. A sudden stop of intrathecal baclofen therapy can result in serious medical problems and, in rare cases, has been fatal. During the refill appointment, it is also important for the clinician to diagnose and correct any problems that may occur with the infusion system. What you need to know about pump refills.
It is very important that both you and your caregivers know and understand the warning signs of baclofen overdose, underdose, and withdrawal. Also, it is very important to contact your doctor right away if you experience any of these warning signs. Know that abruptly stopping intrathecal baclofen can result in serious medical problems and, in rare cases, has been fatal. What you need to know about the warning signs.
Always carry the red Emergency Medical Information card. This pocket-sized card includes the warning signs of intrathecal baclofen overdose and underdose, what to do, and emergency contact information. Your doctor can order copies from a Medtronic representative. You can also print the Emergency Medical Information.
In case of an emergency, your card identifies you as having an implanted device.
Always have an unexpired bottle of oral baclofen. Get instructions from your doctor on using oral medication if there are signs of baclofen withdrawal. Keep in mind that oral baclofen should not be relied on as the only treatment for stopping the progression of intrathecal baclofen withdrawal.
An alarm will sound if there is a problem with the pump or if the pump needs to be replaced or filled with baclofen. Know your pump’s two alarms and what to do if you hear them.
Do not manipulate or rub the pump or catheter through your skin. This can cause skin erosion, damage the pump, or flip the pump so it can’t be refilled. In addition, the catheter could kink or disconnect, which can damage tissue or stop the flow of drug causing dangerous symptoms of baclofen withdrawal. Surgery may be needed to resolve some complications with the pump or catheter.
The Medtronic baclofen pump is part of the Synchromed® Infusion System, which delivers the drug called Lioresal® Intrathecal (baclofen injection) for ITB TherapySM, a treatment for severe spasticity. Please read the following important safety information about ITB Therapy.
Please follow your doctor's instruction closely because a sudden stop of intrathecal baclofen therapy can result in serious baclofen withdrawal symptoms such as high fever, changed mental status, muscle stiffness, and in rare cases may result in loss of function of many vital organs and death. It is very important that your doctor be called right away if you experience any of the above symptoms.
It is important for you to keep your scheduled refill visits so you don't run out of medication (baclofen) and to know the early symptoms of baclofen withdrawal. Some patients are at more risk than others for baclofen withdrawal; speak with your doctor about this.
People who suffer from severe spasticity resulting from cerebral palsy, multiple sclerosis, stroke, brain injury, or spinal cord injury may be candidates for ITB Therapy. If you have spasticity due to spinal cord injury or multiple sclerosis, you may be considered for ITB Therapy if oral baclofen has not controlled your spasticity or has resulted in serious side effects that you cannot accept. If you suffered a brain injury due to trauma you must wait until one year after the injury to be considered for ITB Therapy. A trial of ITB Therapy will help to show if ITB Therapy can help you. You should not receive ITB Therapy if you have an infection, are allergic to baclofen, or your body size is too small for the implantable pump.
The implanted pump and catheter (tube that delivers the drug from the pump to the fluid around the spinal cord) are placed under the skin during a surgery. Some complications that you may experience with the surgery include infection, meningitis (infection of the lining of the brain and central nervous system), spinal fluid leak, paralysis, headache, swelling, bleeding, and bruising.
The most common and/or serious drug-related side effects of ITB Therapy include loose muscles, sleepiness, upset stomach, vomiting, headaches, and dizziness. Failure of the pump placed under your skin may cause symptoms due to overdose (receiving too much) or underdose (receiving too little) of intrathecal baclofen. The signs and symptoms of overdose include drowsiness, lightheadedness, dizziness, respiratory depression (difficulty breathing), hypothermia (lower than normal body temperature), seizures, loss of consciousness, and coma. Once the infusion system (the pump and the catheter) is implanted, possible complications include unintended movement of the catheter or pump within the body or breakdown of the skin over the pump. The catheter could leak, tear, kink, or become disconnected from the pump, resulting in underdose or no baclofen infusion. Symptoms of underdose include an increase or return in spasticity, itching, low blood pressure, lightheadedness, and tingling sensation. These symptoms are often early signs of baclofen withdrawal. The pump could stop because the battery has run out or because of a problem with one or more of its inner parts. The pump will sound an alarm when the pump needs to be filled with baclofen, replaced, or if there is a problem with the pump. You or your caregiver should always inform any healthcare personnel that you have an implanted infusion system before any medical or diagnostic procedure such as MRI or diathermy.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.