Dantrolene Sodium
Dantrolene Sodium (Hydantoin derivative)
También conocido como: Dantrium · Danlene · Dantamacrin · Dantralen · F-440 · F-368 · Dantrolene sodium
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Treatment of functional urethral obstruction due to increased external urethral tone | 1-5 mg/kg PO q8-12h | PO | q8-12h | — | 🌎 NA |
| Treatment of functional urethral obstruction due to increased external urethral tone | 1 mg/kg PO q8h | PO | q8h | — | 🌎 NA |
| Canine stress syndrome (CSS)/Malignant Hyperthermia (MH) - acute attack | 0.2-3 mg/kg IV | IV | Once/PRN | — | 🌎 NA |
| MH-like syndrome associated with hops (Humulus lupulus) ingestion | 2-3 mg/kg IV or 3.5 mg/kg PO as soon as possible after ingestion. | IV/PO | Once | — | 🌎 NA |
| Adjunctive treatment of rhabdomyolysis | 1.5 mg/kg PO q8h | PO | q8h | — | 🌎 NA |
| Adjunctive treatment of Black Widow Spider bite | 1 mg/kg IV ; followed by 1 mg/kg PO q4h | IV, then PO | q4h | — | 🌎 NA |
- Adjunctive treatment of rhabdomyolysis: From a case report; very intensive drug and supportive therapy used in this case.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Treatment of functional urethral obstruction due to increased external urethral tone | 0.5-2 mg/kg PO q12h OR 0.5-1 mg/kg IV | PO/IV | q12h | — | 🌎 NA |
| Treatment of functional urethral obstruction due to increased external urethral tone | 0.5-2 mg/kg PO three times daily | PO | TID | — | 🌎 NA |
| Treatment of functional urethral obstruction due to increased external urethral tone | 2-10 mg (total dose) PO three times daily | PO | TID | — | 🌎 NA |
| Treatment of functional urethral obstruction due to increased external urethral tone | 0.5-1 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
- Treatment of functional urethral obstruction due to increased external urethral tone: IV product very expensive.
- Treatment of functional urethral obstruction due to increased external urethral tone: Given with either prazosin (0.5 mg/cat once to twice daily) or phenoxybenzamine (2.5-7.5 mg/cat once to twice daily).
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Treatment of acute rhabdomyolysis | 15-25 mg/kg slow IV four times daily | IV | QID | — | 🌎 NA |
| Treatment of acute rhabdomyolysis | 2-4 mg/kg PO via nasogastric tube once daily | PO | SID | — | 🌎 NA |
| Prevention of recurrent exertional rhabdomyolysis in Thoroughbreds | 4 mg/kg PO in horses fasted (12-hour fast in study) prior to administration. | PO | Once | — | 🌎 NA |
| Prevention of rhabdomyolysis | 2 mg/kg PO once daily for 3-5 days and then every 3rd day for a month | PO | SID then q3d | 1 month | 🌎 NA |
| Prevention of rhabdomyolysis | 300 mg (total dose) PO once daily | PO | SID | — | 🌎 NA |
| Prevention of rhabdomyolysis | 500 mg (total dose) PO for 3-5 days and then 300 mg PO every third day. | PO | SID then q3d | — | 🌎 NA |
| Prevention of rhabdomyolysis | 800 mg (total dose); within 30 minutes prior to administration contents of capsules mixed with 9 mL tap water to make a suspension and given PO one hour before exercise. | PO | Once before exercise | — | 🌎 NA |
| Prevention of post-anesthetic myositis (PAM) | 6 mg/kg enterally (given via NG tube in study) 60 minutes prior to general anesthesia. | Enteral | Once | — | 🌎 NA |
| Prevention of post-anesthetic myositis (PAM) | 10 mg/kg PO (intragastric) 1.5 hours before surgery. | PO | Once | — | 🌎 NA |
| Prevention of post-anesthetic myositis (PAM) | 1.9 mg/kg loading | IV | Once | — | 🌎 NA |
| Prevention of post-anesthetic myositis (PAM) | 4 mg/kg | IV | Once | — | 🌎 NA |
- Prevention of rhabdomyolysis: Drug is diluted in normal saline and given via stomach tube. Monitor hepatic function.
- Prevention of rhabdomyolysis: May be preferable because the drug is hepatotoxic.
- Prevention of post-anesthetic myositis (PAM): Does not appear to prolong recovery time.
- Prevention of post-anesthetic myositis (PAM): Should give peak levels at the time surgery begins and maintain postulated therapeutic levels for an additional 2 hours. Additional doses of 2.5 mg/kg PO (intragastric) q60 minutes can be given.
- Prevention of post-anesthetic myositis (PAM): Will give therapeutic levels but will only persist for about 20 minutes.
- Prevention of post-anesthetic myositis (PAM): Will maintain therapeutic levels for about 2 hours, but peak levels will be quite high.
Cerdos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Prevention or treatment of malignant hyperthermia | 3.5 mg/kg IV | IV | Once/PRN | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El dantrolene sódico es un relajante muscular esquelético de acción directa único. A diferencia de los relajantes musculares de acción central (como el metocarbamol o el diazepam), el dantrolene actúa periféricamente de forma directa sobre la propia fibra muscular.
En medicina veterinaria, sus indicaciones principales incluyen:
- Hipertermia Maligna (HM): Una intervención que salva vidas para la HM y el síndrome de estrés porcino, particularmente en cerdos y perros.
- Miopatías Equinas: Ampliamente utilizado en caballos para la prevención y el tratamiento de la rabdomiólisis por esfuerzo ("tying-up") y la miositis post-anestésica (MPA).
- Urología en Pequeños Animales: Utilizado frecuentemente para manejar la obstrucción uretral funcional al disminuir el tono del esfínter uretral externo en perros y gatos.
- Envenenamiento por Toxinas: Recomendado como tratamiento adyuvante para las picaduras de araña viuda negra, las cuales causan una liberación masiva de acetilcolina y calambres musculares severos y dolorosos.
Perla Clínica: Debido a que la formulación inyectable es extremadamente costosa y tiene una vida útil corta tras su reconstitución, su uso suele reservarse para crisis agudas severas (como la HM), mientras que las formulaciones orales se utilizan para el manejo crónico o la profilaxis.
Mecanismo de acción
Dantrolene acts intracellularly to uncouple the excitation-contraction process in skeletal muscle.
- It binds specifically to the ryanodine receptor (RyR1) located on the sarcoplasmic reticulum (SR).
- This binding blocks the release of calcium (Ca²⁺) from the SR into the myoplasm.
- Decreased intracellular calcium → prevents the interaction of actin and myosin → produces skeletal muscle relaxation.
Because it specifically targets the RyR1 isoform (found primarily in skeletal muscle) rather than RyR2 (cardiac muscle), it has minimal direct effects on cardiac or smooth muscle at standard therapeutic doses. The exact mechanism for its mild CNS effects (drowsiness, dizziness) remains poorly understood.
Seguridad y advertencias
Contraindicaciones
- Preexisting liver disease (use with extreme caution)
- Severe cardiac dysfunction (use with caution)
- Pulmonary disease (use with caution)
Efectos adversos
- Weakness
- Sedation
- Dizziness
- Headache
- Nausea
- Vomiting
- Constipation
- Increased urinary frequency
- Hypotension
- Hepatotoxicity (especially with chronic use)
Precauciones
Hepatotoxicity Warning: Dantrolene can cause hepatotoxicity. It should be used with extreme caution in patients with preexisting liver disease. Monitor liver enzymes closely during chronic therapy.
- Use with caution in patients with severe cardiac dysfunction or pulmonary disease.
- Pregnancy: FDA Category C (human); Papich Class C (veterinary). Use cautiously as a last resort when benefits clearly outweigh risks.
- Nursing: Distributed into milk; safe use cannot be assured during nursing.
Interacciones farmacológicas
Increased sedation may be seen if tranquilizing agents are used concomitantly.
Rare reports of cardiovascular collapse in humans; concomitant use during malignant hyperthermia crises is not recommended.
Increased risks of hepatotoxicity have been seen in women >35 years of age; veterinary significance is unknown.
Dantrolene may be displaced from plasma proteins by warfarin, resulting in increased effects or adverse reactions.
Monitorización
- Baseline and periodic liver function tests (ALT, AST, Alk Phos, etc.) if projecting to be used chronically or using high dosages
- Body temperature (especially for malignant hyperthermia)
- Urine volume, frequency, continence
Farmacocinética
Vida media
Absorción
Bioavailability after oral administration is ~35% in humans and ~39% in horses (intragastric). Fairly slowly absorbed; peak levels occur ~5 hours post-oral dose in humans and 1.5 hours in horses. In horses, oral absorption is affected by food and must be given to a fasted horse to achieve therapeutic levels.
Distribución
Substantially bound to plasma proteins (principally albumin). Many drugs may displace it.
Metabolismo
Metabolized in the liver.
Eliminación
Metabolites are excreted in the urine. Only about 1% of the parent drug is excreted unchanged in the urine and bile.
Sobredosis
There is no specific antidotal therapy for dantrolene overdoses.
- Decontamination: Remove the drug from the gut if possible (e.g., emesis induction, activated charcoal) if exposure was recent and oral.
- Supportive Care: Treat supportively, monitoring respiratory, cardiovascular, and hepatic function.
Productos disponibles
Formulaciones
- Oral Capsules
- Powder for Injection Solution
Etiquetado para humanos
- Dantrolene Sodium Oral Capsules: 25 mg, 50 mg, & 100 mg (Dantrium; generic)
- Dantrolene Sodium Powder for Injection Solution: 20 mg/vial (approx. 0.32 mg/mL dantrolene after reconstitution; with mannitol 3 g/vial) in 70 mL vials (Dantrium Intravenous)
Estado regulador
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Capsules should be stored in well-closed containers at room temperature. Powder for injection should be stored at temperatures less than 30°C and protected from prolonged exposure to light. After reconstitution, the powder for injection should be used within 6 hours when stored at room temperature and should be protected from direct light. It is NOT compatible with either normal saline or D5W injection.
Información para el cliente
- Efectos esperados: El dantrolene puede causar malestar gastrointestinal leve (vómitos, falta de apetito), aumento de la frecuencia urinaria y sedación (somnolencia o debilidad).
- Advertencia hepática: En casos raros, el dantrolene puede causar toxicidad hepática. Contacte a su veterinario inmediatamente si su mascota presenta vómitos persistentes, pérdida de apetito, letargo profundo inexplicable o coloración amarillenta en el blanco de los ojos o en las encías (ictericia).
- Administración: El uso intravenoso de este medicamento solo debe ser realizado por profesionales veterinarios familiarizados con su uso y los requisitos de monitoreo.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.