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Dantrium
dantrolene
Black Box Warnings .
Hepatotoxicity
use only for recommended conditions at lowest effective dose; D/C tx if no observed benefit after 45 days; frequently monitor hepatic fxn incl. AST/ALT; fatal and non-fatal symptomatic hepatitis reported at various dose levels; lower incidence w/ 400 mg/day compared to >800 mg/day; sporadic short courses >800 mg/day w/in tx regimen markedly incr. risk; elev. LFTs reported w/ various lengths of exposure; hepatitis occurred at varying intervals after tx start, but most frequently between 3rd-12th mo of tx; incr. risk in female pts, pts >35 yo, and w/ concomitant meds; possible higher incidence of fatal outcome in elderly pts, but cases complicated by confounding factors incl. intercurrent illnesses and/or concomitant hepatotoxic meds
Adult Dosing .
Dosage forms: CAP: 25 mg, 50 mg, 100 mg; INJ: various
spasticity, chronic
- [100 mg PO tid-qid]
- Start: 25 mg PO qd x7 days, then 25 mg PO tid x7 days, then 50 mg PO tid x7 days, then 100 mg PO tid; Max: 100 mg PO qid; Info: use lowest effective dose; D/C if no response after 45 days
malignant hyperthermia, acute
- [2.5 mg/kg/dose IV prn up to 10 mg/kg, then 1 mg/kg/dose IV q4-6h for at least 24h]
- Info: initial doses >10mg/kg/dose may be required for pts w/ persistent sx
neuroleptic malignant syndrome (off-label)
- [1 mg/kg/dose IV q6h]
- Start: 1-2.5 mg/kg/dose IV x1; Max: 10 mg/kg/day; Info: when pt stable, may switch to 4-8 mg/kg/day PO divided qid x7-10 days
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [spasticity]
- active hepatic dz: contraindicated
- [malignant hyperthermia]
- active hepatic dz: not defined
Peds Dosing .
- Dosage forms: CAP: 25 mg, 50 mg, 100 mg; INJ: various
spasticity, chronic
- [5 yo and older]
- Dose: 6-8 mg/kg/day PO divided tid-qid; Start: 0.5 mg/kg/dose PO qd x7 days, then 0.5 mg/kg/dose PO tid x7 days, then 1 mg/kg/dose PO tid x7 days, then 2 mg/kg/dose PO tid; Max: 100 mg PO qid; Info: use lowest effective dose; D/C if no response after 45 days
malignant hyperthermia, acute
- [2.5 mg/kg/dose IV prn up to 10 mg/kg, then 1 mg/kg/dose IV q4-6h for at least 24h]
- Info: initial doses >10mg/kg/dose may be required for pts w/ persistent sx
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [spasticity]
- active hepatic dz: contraindicated
- [malignant hyperthermia]
- active hepatic dz: not defined