DANTROLENE sodium, 20mg, powder, vial

• Not in the WHO list of Essential Medicines 2023

Muscle relaxant, directly acting agent

Anaesthetic-induced malignant hyperthermia, in combination with appropriate supportive measures.
Malignant hyperthermia can be triggered by many drugs, including inhalational anaesthetic agents (isoflurane, sevoflurane, halothane...) and succinylcholine.

Reconstitute the powder vial with 60 ml of water for injection. Shake the vial until complete dissolution of the contents.

The reconstituted solution must be filtered using the single-use filtration device provided when drawing up the solution into the syringe.

Remove the filtration device from the syringe before connecting it to an IV catheter or IV infusion line.

Must be given as rapid IV injection (bolus) as soon as malignant hyperthermia reaction is recognised (i.e., tachycardia, tachypnoea, central venous desaturation, hypercarbia, metabolic acidosis, skeletal muscle rigidity, increased utilisation of anaesthesia circuit carbon dioxide absorber, cyanosis, mottling of the skin, and, in many cases, fever).

Posology: 2.5mg/kg body weight (8-10 vials in adults). In most cases, a total dose of 10mg/kg body weight per 24hrs is sufficient.

Dantrolene should only be administered by physicians specialised in anaesthesia or intensive care, in hospital settings equipped with ventilation assistance and resuscitation equipment.

Dantrolene sodium should be stocked in operating suites and must be available for use within 10 minutes of recognising a malignant hyperthermia crisis.

Contact your anaesthesia advisor for more details on posology and actions to be taken.