단트롤렌 나트륨
Dantrolene Sodium
Dantrolene Sodium (Hydantoin derivative)
다른 이름: Dantrium · Danlene · Dantamacrin · Dantralen · F-440 · F-368 · Dantrolene sodium
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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).
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
돼지
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Prevention or treatment of malignant hyperthermia | 3.5 mg/kg IV | IV | Once/PRN | — | 🌎 NA |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
단트롤렌 나트륨은 독특한 직접 작용형 골격근 이완제입니다. 중추성 근육 이완제(메토카르바몰이나 디아제팜 등)와 달리 말초 근육 섬유에 직접 작용합니다.
수의학에서의 주요 적응증은 다음과 같습니다:
- 악성 고열증(MH): 특히 돼지와 개에서 악성 고열증 및 돼지 스트레스 증후군에 대한 구명약입니다.
- 말의 근육 병증: 말의 운동성 횡문근 융해증 및 마취 후 근염(PAM) 예방 및 치료에 널리 사용됩니다.
- 소동물 비뇨기과: 개와 고양이의 외부 요도 괄약근 긴장을 낮춰 기능성 요도 폐쇄를 관리하는 데 자주 활용됩니다.
- 독소 교상: 대량의 아세틸콜린 방출과 심한 근육 경련을 유발하는 검은과부거미 교상의 보조 치료제로 권장됩니다.
임상 요점: 주사제는 매우 비싸고 재구성 후 유통기한이 짧기 때문에 주로 심각하고 급성인 위기(예: MH)에만 사용되며, 경구제는 만성 관리나 예방 목적으로 사용됩니다.
작용 기전
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.
안전성·주의사항
금기사항
- Preexisting liver disease (use with extreme caution)
- Severe cardiac dysfunction (use with caution)
- Pulmonary disease (use with caution)
부작용
- Weakness
- Sedation
- Dizziness
- Headache
- Nausea
- Vomiting
- Constipation
- Increased urinary frequency
- Hypotension
- Hepatotoxicity (especially with chronic use)
주의
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.
약물 상호작용
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.
모니터링
- 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
약동학
반감기
흡수
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.
분포
Substantially bound to plasma proteins (principally albumin). Many drugs may displace it.
대사
Metabolized in the liver.
배설
Metabolites are excreted in the urine. Only about 1% of the parent drug is excreted unchanged in the urine and bile.
과다투여
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.
제품
제형
- Oral Capsules
- Powder for Injection Solution
인용의약품
- 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)
규제 현황
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
- 예상되는 부작용: 단트롤렌은 가벼운 위장 장애(구토, 식욕 부진), 배뇨 빈도 증가, 진정(졸음 또는 무기력)을 유발할 수 있습니다.
- 간 독성 경고: 드물게 간 독성을 유발할 수 있습니다. 반려동물이 지속적인 구토, 식욕 부진, 원인을 알 수 없는 심한 무기력증, 또는 눈의 흰자위나 잇몸이 노랗게 변하는 증상(황달)을 보이면 즉시 수의사에게 연락하십시오.
- 투여: 이 약의 정맥 주사는 사용 및 모니터링 요구 사항에 능숙한 수의학 전문가에 의해서만 투여되어야 합니다.
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