Muscle spasticity (due to its short duration of action reserve for when relief is most important).
Initially: usually 4mg, may increase by 2–4mg as needed every 6–8 hrs to a max of 3 doses in 24hrs; max 12mg/dose and 36mg/day. Renal impairment (CrCl <25mL/min): reduce dose. May sprinkle contents of capsules on applesauce (may affect absorption). Tabs and caps not bioequivalent under fed conditions. See literature.
Concomitant fluvoxamine, ciprofloxacin.
Hepatic dysfunction. Monitor ophthalmic and liver function (aminotransferases at baseline, 1, 3, 6 months, then periodically) and for orthostatic hypotension. Renal dysfunction. Cardiovascular disease. Avoid abrupt cessation. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers.
Avoid other α2-agonists (eg, clonidine). Hypotension possible with other antihypertensives. Avoid concomitant use with other CYP1A2 inhibitors (eg, amiodarone, mexiletine, propafenone, verapamil, cimetidine, famotidine, other fluoroquinolones, oral contraceptives, acyclovir, ticlopidine, zileuton); if clinically necessary, use caution. May potentiate CNS depression with alcohol, baclofen, benzodiazepines, other CNS depressants.
Dry mouth, somnolence, asthenia, dizziness, UTI, constipation, liver injury or elevated liver enzymes, vomiting, speech disorder, blurred vision, dyskinesia, nervousness, pharyngitis, hypotension, bradycardia, hallucinations/psychosis.