Parenteral Manual

Dantrolene sodium

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
DANTRIUM®
Classification: 
Skeletal muscle relaxant
Original Date: 
August 2005
Revised Date: 
April 2010
Indications: 
  • Management of malignant hyperthermia crisis
  • For pre-operative prophylaxis in individuals at risk of malignant hyperthermia
Reconstitution and Stability: 

VIAL SIZE

STERILE WATER for INJECTION  REQUIRED

FINAL CONCENTRATION

20 mg

60 mL

0.33 mg/mL (shake vial until solution is clear)
  • Store at room temperature                                               
  • Reconstituted solution stable 6 hours at room temperature                         

  • Protect from light

Compatibility: 

- Solutions Compatible: Sterile Water for Injection 

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: no information

- Incompatible: D5W, 0.9% NaCl, bacteriostatic water, do not mix with other drugs

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Push

YES
Usual dilution: undiluted (0.33 mg/mL)
Infusion time: over 1-2 minutes
IV Intermittent Infusion YES
Usual dilution: undiluted (0.33 mg/mL)
Infusion time: 60 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Adult/Pediatric:
- Malignant Hyperthermia Crisis:  

  • 1mg/kg IV push
  • Repeat prn up to a maximum cumulative dose of 10 mg/kg/day
  • Following resolution of the crisis, continue with oral dantrolene at 4-8 mg/kg day ÷ QID for 3 days

- Preoperative prophylaxis:

  • 2.5 mg/kg 1¼ hours before surgery; infuse over 1 hour; may repeat during surgery if prolonged surgery                
Potential hazards of parenteral administration: 
  • Phlebitis         
  • Avoid extravasation; IV formulation has a high pH and may cause local tissue damage
  • Rash, urticaria, pruritis
  • Muscle weakness which rarely may result in slurred speech, drooling and enuresis
  • Drowsiness, dizziness, malaise, fatigue
  • Nausea, diarrhea
  • Hepatitis
  • Tachycardia, hematuria
Notes: 
  • Do not use calcium channel blockers in combination with dantrolene due to possible cardiac depression and hyperkalemia
  • Monitor transaminases to detect hepatotoxicity, temperature (hyperthermia)
  • 3 g mannitol in each 20 mg vial

               

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