DANTROLENE

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

Dosages

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

Mechanism of Action

Skeletal muscle relaxant

Forms Supplied

capsule: 25 mg, 100 mg
injection: 20 mg/vial

Comments

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

References

44, 128, 463, 495 - 497

Last Edited

2021-08-01 20:51:35