A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Dantrium Side Effects, and Drug Interactions - Dantrolene Sodium
Dantrium Side Effects, and Drug Interactions - Dantrolene Sodium
SIDE EFFECTS
There have been occasional reports of death following malignant hyperthermia
crisis even when treated with intravenous dantrolene: incidence figures
are not available (the pre-dantrolene mortality of malignant hyperthermia
crisis was approximately 50%). Most of these deaths can be accounted for
by late recognition, delayed treatment, inadequate dosage, lack of supportive
therapy, intercurrent disease and/or the development of delayed complications
such as renal failure or disseminated intravascular coagulopathy. In some
cases there are insufficient data to completely rule out therapeutic failure
of dantrolene.
There are rare reports of fatality in malignant hyperthermia crisis,
despite initial satisfactory response to I.V. dantrolene, which involve
patients who could not be weaned from dantrolene after initial treatment.
The administration of intravenous Dantrium to human volunteers is associated
with loss of grip strength and weakness in the legs, as well as drowsiness
and dizziness.
The following adverse reactions are in approximate order of severity:
There are rare reports of pulmonary edema developing during the treatment
of malignant hyperthermia crisis in which the diluent volume and mannitol
needed to deliver I.V. dantrolene possibly contributed.
There have been reports of thrombophlebitis following administration
of intravenous dantrolene: actual incidence figures are not available.
There have been rare reports of urticaria and erythema possibly associated
with the administration of I.V. Dantrium. There has been one case of anaphylaxis.
None of the serious reactions occasionally reported with long-term oral
Dantrium use, such as hepatitis, seizures, and pleural effusion with pericarditis,
have been reasonably associated with short-term Dantrium Intravenous therapy.
The following events have been reported in patients receiving oral dantrolene:
aplastic anemia, leukopenia, lymphocytic lymphoma, and heart failure.(See
package insert for Dantrium (dantrolene sodium) Capsules for a complete
listing of adverse reactions.)
The published literature has included some reports of Dantrium use in
patients with Neuroleptic Malignant Syndrome (NMS). Dantrium Intravenous
is not indicated for the treatment of NMS and patients may expire despite
treatment with Dantrium Intravenous.
DRUG INTERACTIONS
Dantrium is metabolized by the liver, and it is theoretically possible
that its metabolism may be enhanced by drugs known to induce hepatic microsomal
enzymes. However, neither phenobarbital nor diazepam appears to affect
Dantrium metabolism. Binding to plasma protein is not significantly altered
by diazepam, diphenylhydantoin, or phenylbutazone. Binding to plasma proteins
is reduced by warfarin and clotibrate and increased by tolbutamide.
Cardiovascular collapse in patients treated simultaneously with varapamil
and dantrolene sodium is rare. The combination of therapeutic doses of
intravenous dantrolene sodium and verapamil in halothane/a-chloralose
anesthetized swine has resulted in ventricular fibrillation and cardiovascular
collapse in association with marked hyperkalemia. It is recommended that
the combination of intravenous dantrolene sodium and calcium channel blockers,
such as verapamil, not be used together during the management of malignant
hyperthermia crisis until the relevance of these findings to humans is
established.
Administration of dantrolene may potentiate vecuronium-induced neuromuscular
block.
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