Pre Op⁄Post Op
Preoperatively: Dantrium® Intravenous and/or Dantrium® Capsules may be administered preoperatively to patients judged malignant hyperthermia susceptible as part of the overall patient management to prevent or attenuate the development of clinical and laboratory signs of malignant hyperthermia.
Dantrium® Intravenous: The recommended prophylactic dose of Dantrium® Intravenous is 2.5 mg/kg, starting approximately 1-1/4 hours before anticipated anesthesia and infused over approximately 1 hour. This dose should prevent or attenuate the development of clinical and laboratory signs of malignant hyperthermia provided that the usual precautions, such as avoidance of established malignant hyperthermia triggering agents, are followed.
Additional Dantrium® Intravenous may be indicated during anesthesia and surgery because of the appearance of early clinical and/or blood gas signs of malignant hyperthermia or because of prolonged surgery (see also CLINICAL PHARMACOLOGY, WARNINGS, and PRECAUTIONS). Additional doses must be individualized.
Oral Administration of Dantrium® Capsules: Administer 4 to 8 mg/kg/day of oral Dantrium® in three or four divided doses for 1 or 2 days prior to surgery, with the last dose being given with a minimum of water approximately 3 to 4 hours before scheduled surgery. Adjustment can usually be made within the recommended dosage range to avoid incapacitation (weakness, drowsiness, etc.) or excessive gastrointestinal irritation (nausea and/or vomiting). See also the package insert for Dantrium® Capsules.
Post Crisis Follow-Up: Dantrium® Capsules, 4 to 8 mg/kg/day, in four divided doses should be administered for 1 to 3 days following a malignant hyperthermia crisis to prevent recurrence of the manifestations of malignant hyperthermia.
Intravenous Dantrium® may be used postoperatively to prevent or attenuate the recurrence of signs of malignant hyperthermia when oral Dantrium® administration is not practical. The i.v. dose of Dantrium® in the postoperative period must be individualized, starting with 1 mg/kg or more as the clinical situation dictates.