Dantrolene Sodium

Adults: For use in chronic spasticity, adults: the following gradual titration schedule is suggested. Some patients will not respond until a higher daily dosage is achieved. Each dosage level should be maintained for seven days to determine the patient's response. If no further benefit is observed at the next higher dose, the dosage should be decreased to the previous lower dose. The starting dose is 25 mg twice per day, and it can be increased by 25 to 50 mg per day each week. The maximum accepted dosage is 400 mg per day. Paediatric patients: the following gradual titration schedule is suggested. Some patients will not respond until a higher daily dosage is achieved. Each dosage level should be maintained for seven days to determine the patient's response. If no further benefit is observed at the next higher dose, the dosage should be decreased to the previous lower dose. Give 0.5 mg/kg once daily for seven days, then 0.5 mg/kg 3 times daily for 7 days, then 1 mg/kg 3 times daily for 7 days, then 2 mg/kg 3 times a day. Therapy with a dose 4 times daily may be necessary for some individuals. For malignant hyperthermia, preoperatively: administer 4 to 8 mg/kg/day of oral Dantrolene in 3 or 4 divided doses for one or two days prior to surgery, with the last dose given approximately 3 to 4 hours before the scheduled surgery with a minimum of water. Post crisis follow-up: oral Dantrolene should also be administered following a malignant hyperthermia crisis, in doses of 4 to 8 mg/kg per day in four divided doses, for a one to three day period to prevent recurrence of the manifestations of malignant hyperthermia.