dantrolene
Dantrolene sodium is a muscle relaxant. Dantrolene (Dantrium) is used for muscle stiffness or spasms (spasticity), including a severe and potentially life-threatening problem in people receiving surgery called malignant hyperthermia. Dantrolene (Dantrium) is taken by mouth, typically 3 to 4 times per day, by adults and children ages 5 years and older. Dantrolene sodium is also available as injections (Ryanodex and Revonto) given in hospital settings. Some side effects of dantrolene (Dantrium) include sleepiness, dizziness, and diarrhea.
What is Dantrolene (Dantrium)?
What is Dantrolene (Dantrium) used for?
- Long-term muscle spasticity from certain nerve-related conditions
- Prevent or lessen the severity of malignant hyperthermia before procedures
How Dantrolene (Dantrium) works
Dantrolene (Dantrium) is a muscle relaxant. It's not exactly known how dantrolene (Dantrium) works, but it's thought to block the release of calcium in muscles, which stops your muscles from contracting.
Drug facts
Side effects of Dantrolene (Dantrium)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness
- Sleepiness
- Weakness
- Tiredness
- Fatigue
- Diarrhea
Less Common Side Effects
- Loss of appetite
- Difficulty swallowing
- Upset stomach
- Nausea
- Vomiting
- Headache
- Feeling lightheaded
- Change in vision
- Trouble sleeping
- Fast heart beat
- Slurred speech
Dantrolene (Dantrium) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver problems: stomach bloating, yellowing of your skin or the whites of your eyes, dark urine
More on Dantrolene (Dantrium) side effects
The following Dantrolene (Dantrium) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Serious side effects are very rare when dantrolene is taken for a short time, for example, when it is used for a few days before, during, or after surgery or anesthesia to prevent or treat malignant hyperthermia. However, serious side effects may occur, especially when the medicine is taken for a long time.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bloody or black, tarry stools
bloody or dark urine
bluish color changes in skin color
changes in speech
confusion
convulsions (seizures)
decrease in frequency of urination
decrease in urine volume
difficult urination
difficulty in moving
difficulty in passing urine (dribbling)
difficulty in swallowing
fast, pounding, or irregular heartbeat or pulse
increased frequency of urination
increased urge to urinate during the night
joint pain
light-colored stools
lightheadedness
loss of bladder control
mental depression
muscle aching or cramping
muscle pains or stiffness
muscle spasm or jerking of all extremities
pain in lower back
pain or burning while urinating
pain, tenderness, or changes in skin color
severe stomach pain
shortness of breath
slow or troubled breathing
sudden decrease in amount of urine
sudden loss of consciousness
swelling of foot or leg
swollen joints
unusual tiredness or weakness
upper right abdominal pain
vomiting of blood or material that looks like coffee grounds
waking to urinate at night
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Abdominal or stomach cramps or discomfort
abnormal hair growth
acne-like rash
blurred or double vision or any change in vision
change in taste
chills and fever
disturbed color perception
excessive tearing
halos around lights
headache
itching skin
loss of appetite
night blindness
overbright appearance of lights
redness of skin
seeing double
skin rash, encrusted, scaly and oozing
slurring of speech or other speech problems
sudden decrease in amount of urine
sweating
trouble in sleeping
tunnel vision
unable to sleep
unusual nervousness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Dantrolene (Dantrium)
Pros
- Taken by mouth
- Available as a lower-cost generic form
- Might be an option for children as young as 5 years old
Cons
- Taken multiple times a day
- Can cause drowsiness and dizziness
- Raises risk for serious liver problems
Pharmacist tips for Dantrolene (Dantrium)
- If you're taking dantrolene (Dantrium) to prevent malignant hyperthermia during surgery, make sure you know when you should start the medication and when to stop. Usually the last dose is taken three or four hours before surgery.
- You can take dantrolene (Dantrium) with or without food, but if it upsets your stomach, try taking it with food to help.
- Swallow dantrolene (Dantrium) capsules whole. Don't open, chew, or crush them. If you're having trouble swallowing the capsules, let your provider know.
- Tell your provider about all the prescription and over-the-counter medications you're taking before starting dantrolene (Dantrium). Some medications can interact with dantrolene (Dantrium) and cause more severe side effects. For example, taking benzodiazepines, sleep medications, or anxiety medications can worsen sleepiness and dizziness. Don't start any new medications until you've asked your provider or pharmacist if it's safe to take with dantrolene (Dantrium).
- Diarrhea is a common side effect. Make sure to stay hydrated. If the diarrhea isn't getting better, let your provider know. You'll likely need to lower your dose or stop the medication.
- Dantrolene (Dantrium) can cause sleepiness and dizziness, which raises your risk for falls and affect your ability to think, focus, and react. Don't drive, operate machinery, or do anything that requires concentration until you know how this medication affects you.
- Avoid drinking alcohol while taking dantrolene (Dantrium) because doing so can worsen dizziness and sleepiness. In addition, alcohol can damage the liver, which can raise your risk for liver problems from dantrolene (Dantrium).
- Side effects from dantrolene (Dantrium), such as dizziness and tiredness, are more likely to happen when you first start taking the medication and with dose changes. They should get better over time as your body gets used to the medication. But if you're having side effects that are too bothersome, let your provider know. You might need to lower the dose or stop taking the medication.
- Dantrolene (Dantrium) can make your skin more sensitive to the sun. To protect your skin, make sure to wear sunscreen when going outside, wear long-sleeved clothing, and avoid being exposed to light or sun for a long time as much as possible.
Common questions about Dantrolene (Dantrium)
It might take about one and a half hours for dantrolene (Dantrium) to start working. If you're taking dantrolene (Dantrium) to help prevent malignant hyperthermia before surgery, your provider will ask you to start this medication 1 to 2 days before your procedure to give it time to work. Keep in mind that everyone responds differently to medications. Talk to your provider if you're concerned with how quickly dantrolene (Dantrium) is working for you.
No, dantrolene (Dantrium) isn't a controlled substance because it doesn't have a risk of dependence or addiction.
Both dantrolene (Dantrium) and baclofen are muscle relaxants approved for long-term muscle spasm or stiffness (spasticity). One difference between them is that dantrolene (Dantrium) is also approved for malignant hyperthermia, while baclofen isn't. Another difference is that dantrolene (Dantrium) can raise the risk for serious liver problems, but baclofen doesn't carry the same risk. Both medications haven't been directly compared to each other, so it's not known if one works better than the other.
No, dantrolene (Dantrium) isn't typically used to treat serotonin syndrome, a condition where serotonin levels in your body get too high. While symptoms of serotonin syndrome can include muscle stiffness, dantrolene (Dantrium) doesn't block serotonin and isn't approved to treat this condition.
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Risks and warnings for Dantrolene (Dantrium)
Dantrolene (Dantrium) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver injury
- Risk factors: Taking at least 800 mg of dantrolene (Dantrium) per day | Taking other medications that cause liver damage | Females | Adults ages 35 years and older
Dantrolene (Dantrium) can cause serious and sometimes life-threatening liver damage. While liver problems can develop any time, it's more commonly reported by people who've taken dantrolene (Dantrium) for 3 months or longer. Sometimes, people who have liver problems might not feel any physical symptoms, so your provider will order blood tests regularly to check your liver health. To lower your risk of liver damage, your provider might ask you to stop taking dantrolene (Dantrium) after 45 days if this medication still hasn't helped your condition.
Let your provider know about all the medications you're taking before you start dantrolene (Dantrium) so they can see if you're taking other medications that can cause liver damage, like acetaminophen (Tylenol). Get medical attention if you notice stomach bloating or pain, yellowing of your skin or the whites of your eyes, stool changes (black, tarry, or bloody stools), or dark or brown urine.
Dantrolene (Dantrium) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 90 capsules | $30.27 | $0.34 |
| 100mg | 120 capsules | $59.66 | $0.50 |
| 50mg | 90 capsules | $43.76 | $0.49 |
Typical dosage for Dantrolene (Dantrium)
Chronic spasticity
- Adults: The typical starting dose is 25 mg by mouth once a day. If needed, your provider might raise your dose every week. The typical maintenance dose ranges from 25 mg to 100 mg three times a day. The maximum dose is 100 mg four times a day.
- Children (ages 5 years and older): Your child's provider will determine the dose based on your child's body weight. The typical starting dose is 0.5 mg/kg by mouth once a day. If needed, your provider might raise your dose every week. The typical maintenance dose ranges from 0.5 mg/kg to 2 mg/kg (up to 100 mg) three times a day.
Malignant hyperthermia
- Your provider will determine your dose based on your body weight. The typical dose ranges from 4 mg/kg to 8 mg/kg daily, taken by mouth in 3 to 4 divided doses. You'll usually start this medication 1 to 2 days before surgery. And if you experience a malignant hyperthermia episode, your provider will ask you to continue this medication for 1 to 3 days after surgery to prevent future episodes from happening.
Dantrolene is also available as an injection (IV) (Revonto, Ryanodex) for the prevention or treatment of malignant hyperthermia in people in the hospital.
Interactions between Dantrolene (Dantrium) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alprazolam
- Amlodipine
- Amobarbital
- Aprobarbital
- Buprenorphine
- Butabarbital
- Butalbital
- Calcium Oxybate
- Carisoprodol
- Chloral Hydrate
- Chlordiazepoxide
- Chlorzoxazone
- Cinnarizine
- Clevidipine
- Clobazam
- Clonazepam
- Clorazepate
- Diazepam
- Diltiazem
- Estazolam
- Ethchlorvynol
- Felodipine
- Flunitrazepam
- Flurazepam
- Halazepam
- Isradipine
- Ketazolam
- Lorazepam
- Lormetazepam
- Magnesium Oxybate
- Medazepam
- Mephenesin
- Mephobarbital
- Meprobamate
- Metaxalone
- Methadone
- Methocarbamol
- Methohexital
- Methotrexate
- Midazolam
- Nicardipine
- Nifedipine
- Nimodipine
- Nisoldipine
- Nitrazepam
- Oxazepam
- Pentobarbital
- Pexidartinib
- Phenobarbital
- Potassium Oxybate
- Prazepam
- Primidone
- Quazepam
- Secobarbital
- Sodium Oxybate
- Temazepam
- Thiopental
- Triazolam
- Verapamil
How much does Dantrolene (Dantrium) cost?
Dantrolene (Dantrium) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Dantrolene (Dantrium) will not be safe for you to take.
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