MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Skeletal muscle relaxants and spasticity

NICE Guidance (see also drug-specific links below)

 NG42: Motor neurone disease: assessment and management, updated July 2019.

CG145: Spasticity in under 19s: management, November 2016.

NG220: Multiple Sclerosis in adults: management, June 2022

See management of multiple sclerosis in adults.

Baclofen and dantrolene are used for the relief of chronic muscle spasm or spasticity associated with multiple sclerosis or other neurological damage. They are not indicated for spasm associated with minor injuries.

Dantrolene acts directly on skeletal muscle and produces fewer central adverse effects. Dose should be increased slowly. It is also used in Malignant Hyperthermia.

Baclofen inhibits transmission at spinal level and may also depress the central nervous system. Dose should be increased slowly to avoid major side effects of sedation and muscular hypotonia. Withdrawal of treatment should also be gradual.

Diazepam may be used but sedation is a disadvantage. Muscle relaxant doses are similar to anxiolytic doses.

Sativex oromucosal spray - please refer to the shared care prescribing guidelines for its use in treatment of spasticity in patients with multiple sclerosis.

Pack Price
84 tablet (6 x 14 tablets) £4.62
Pack Price
300 ml £3.75
Pack Price
100 capsule £16.87
Pack Price
100 capsule £43.07
Pack Price
270 dose (3 x 90 doses) £300.00