Indications: spasticity associated with multiple sclerosis or spinal cord injury or disease

Cautions: elderly; monitor liver function monthly for first 4 months and in those who develop unexplained nausea, anorexia or fatigue; concomitant administration of drugs that prolong QT interval; avoid abrupt withdrawal (risk of rebound hypertension and tachycardia.

Contra-indications: pregnancy, breast feeding.

Side Effects: dry mouth, nausea, gastro-intestinal disturbance, altered liver enzymes, hypotension, drowsiness, fatigue, dizziness.

Dose: ADULT over 18 years, initially 2 mg daily as a single dose increased according to response at intervals of at least 3–4 days in steps of 2 mg daily (and given in divided doses) usually up to 24 mg daily in 3–4 divided doses; max. 36 mg daily.