Formulary
Dantrolene sodium: Indications, Dosing, Side Effects and Interactions
Acts on skeletal muscle cells by interfering with calcium efflux, thereby stopping the contractile process.
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Dantrolene sodium: Indications, Dosing, Side Effects and Interactions
Acts on skeletal muscle cells by interfering with calcium efflux, thereby stopping the contractile process.
Drug action
Acts on skeletal muscle cells by interfering with calcium efflux, thereby stopping the contractile process.
Indications and dose
**Chronic severe spasticity of voluntary muscle**
- **Adult** (By Mouth): Initially 25 mg daily, then increased to up to 100 mg 4 times a day, dose increased at weekly intervals; usual dose 75 mg 3 times a day.
**Muscle cramps in motor neurone disease (specialist use only)**
- **Adult** (By Mouth): Initially 25 mg daily, then increased to up to 100 mg 4 times a day, dose increased at weekly intervals.
**Malignant hyperthermia for dantrolene sodium**
- **Child** (By rapid intravenous injection): Initially 2-3 mg/kg, then 1 mg/kg, repeated if necessary; maximum 10 mg/kg per course.
**Chronic severe spasticity of voluntary muscle for dantrolene sodium**
- **Child 5-11 years** (By mouth): Initially 500 micrograms/kg once daily for 7 days, then increased to 500 micrograms/kg/dose 3 times a day, then increased in steps of 500 micrograms/kg/dose every 7 days (max. per dose 2 mg/kg 3-4 times a day) until satisfactory response; maximum 400 mg per day.
- **Child 12-17 years** (By mouth): Initially 25 mg once daily for 7 days, then increased to 25 mg 3 times a day, then increased in steps of 500 micrograms/kg/dose every 7 days (max. per dose 2 mg/kg 3-4 times a day) until satisfactory response; maximum 400 mg per day.
Cautions
With intravenous use Avoid extravasation (risk of tissue necrosis) With oral use Females (hepatotoxicity); history of liver disorders (hepatotoxicity); if doses greater than 400 mg daily (hepatotoxicity); impaired cardiac function; impaired pulmonary function; patients over 30 years (hepatotoxicity); therapeutic effect may take a few weeks to develop- discontinue if no response within 6-8 weeks
Contraindications
With oral use Acute muscle spasm; avoid when spasticity is useful, for example, locomotion
Side effects
General side-effects: Common or very common Asthenia; diarrhoea; dizziness; drowsiness; gastrointestinal discomfort; headache; hepatic disorders; muscle weakness; nausea; respiratory disorders; seizure; skin reactions; speech disorder; vomiting Uncommon Arrhythmias; crystalluria; heart failure; hyperhidrosis Specific side-effects: Common or very common With oral use Appetite decreased; cardiac inflammation; chills; confusion; depression; fever; insomnia; malaise; nervousness; vision disorders Uncommon With oral use Anaemia; aplastic anaemia; back pain; constipation; dysphagia; dyspnoea; excessive tearing; haemorrhage; hair growth abnormal; hallucination; hypersalivation; leucopenia; myalgia; neoplasms; photosensitivity reaction; taste altered; thrombocytopenia; urinary disorders Rare or very rare With oral use Erectile dysfunction Frequency not known With intravenous use Gastrointestinal haemorrhage; hyperkalaemia; muscle fatigue; pulmonary oedema; thrombophlebitis With oral use Dry mouth; muscle tone decreased; pericardial effusion; urine discolouration
Interactions
**Other interactions (2):**
- Concomitant intake of CNS depressants (such as benzodiazepine-type tranquillisers, antihistamines, sedatives) and alcohol consumption should be avoided, as the adverse reactions to Dantrium may be...
- In patients predisposed to malignant hyperthermia who were receiving intravenous dantrolene, it was observed that co-administration of calcium antagonists and/or beta-blockers led to hyperkalaemia...
Pregnancy
With intravenous use: Use only if potential benefit outweighs risk. With oral use: Although teratological studies in animals have proved satisfactory, dantrolene sodium does cross the placenta, therefore manufacturer advises avoid.
Breast feeding
With intravenous use: Present in milk-use only if potential benefit outweighs risk. With oral use: Present in milk-manufacturer advises avoid.
Hepatic impairment
With oral use: Manufacturer advises avoid in hepatic impairment.
Medicinal forms
Solution,Capsule,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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