What is the role of dantrolene sodium in the treatment of spasticity?

Updated: Mar 01, 2018
  • Author: Krupa Pandey, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Dantrolene sodium is useful for spasticity of supraspinal origin, particularly in patients with cerebral palsy or traumatic brain injury (TBI); it acts by decreasing muscle tone, clonus, and muscle spasm. The drug acts at the level of the muscle fiber, reducing muscle contraction by affecting the release of calcium from the sarcoplasmic reticulum of skeletal muscle. It is, therefore, less likely than the other agents to cause adverse cognitive effects. Its peak effect is at 4-6 hours, with a half-life of 6-9 hours. The dose range is 25-400 mg/day in divided doses (in children, the dose range 0.5-3.0 mg/kg/day).

Adverse effects include drowsiness, dizziness, fatigue, diarrhea, and generalized weakness, including weakness of the respiratory muscles. Hepatotoxicity occurs in less than 1% of patients; elevation in liver function test results is seen particularly in adolescents and women who have been treated for more than 60 days and at dosages of greater than 300 mg/day.

Dantrolene should not be used with other agents known to cause hepatotoxicity, including tizanidine. If no benefit is seen after 4-6 weeks of treatment at maximal therapeutic doses, the medication should be discontinued. [20]


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