DRUG SUPPLIED DOSE COMMENTS
DANTROLENE (Paeds)


Mechanism of action:

Skeletal muscle relaxant



Ref:
44, 128, 463, 495 - 497



Last update: 2021-08-01		 capsule: 25 mg, 100 mg
injection: 20 mg/vial		 Spasticity
Children >5 years:
Initial:  0.5 mg/kg/dose (max 25 mg/dose) PO once daily or BID x 7 days
Increment:  Increase frequency to TID x 7 days then increase to 1 mg/kg/dose PO TID (max 50 mg/dose) x 7 days, then 2 mg/kg/dose PO TID (max 100 mg/dose). 
Maximum: 12 mg/kg/24 hr or 400 mg/24 hr, whichever is lower.

Malignant Hyperthermia
2.5 mg/kg IV, repeat q5-10min until patient is stabilized. A ceiling dose of 10 mg/kg is recommended, however, >10 mg/kg may be required for patients with persistent contractures or rigidity
Titrate to desired effect.

Adverse effects include weakness, drowsiness,  and irritability when used for spasticity.

May cause hepatotoxicity. Baseline LFTs should be checked prior to starting treatment, tested weekly during dose titration and every 1-2 months thereafter. Discontinue drug if liver enzymes become elevated.

Malignant Hyperthermia
Key indicators of stability include: declining or normal ETCO2, absence of dysrhythmias, resolving hyperthermia and rigidity



Standard Prescription:

dantrolene__mg PO__(frequency) (__mg/kg/24hr)

dantrolene__mg (__mg/kg/dose) IV Q__H to maximum of __ (max __mg/kg)

dantrolene__mg/kg/hr IV continuous infusion