Baclofen Dosing for GERD

Indication and Patient Selection

• The American Gastroenterological Association recommends baclofen for GERD patients with regurgitation or belch-predominant symptoms, as an adjunctive agent personalized to specific GERD phenotypes 1, 2, 3
• Baclofen is indicated for patients with primary symptoms of regurgitation or belch-predominant symptoms, and as a secondary indication for mild regurgitation symptoms 1, 2, 3
• The mechanism of baclofen is through GABA-B receptor agonism, which inhibits transient lower esophageal sphincter relaxations (TLESRs) 1, 2

Standard Dosing Regimen

• The recommended dosing for baclofen is 10 mg three times daily, with a total daily dose of 30 mg, although this is often limited by central nervous system and gastrointestinal side effects 1, 2

Critical Limitations and Side Effects

• The American Gastroenterological Association notes that central nervous system and GI side effects frequently limit baclofen use, with common side effects including drowsiness, dizziness, and muscle weakness 1, 2
• Baclofen remains an adjunctive rather than primary GERD therapy due to tolerability issues, which are the primary reason for its limited use 1, 2