Saturday, August 27, 2011

Ciprofloxacine Baxter




Ciprofloxacine Baxter may be available in the countries listed below.


Ingredient matches for Ciprofloxacine Baxter



Ciprofloxacin

Ciprofloxacin is reported as an ingredient of Ciprofloxacine Baxter in the following countries:


  • Netherlands

International Drug Name Search

Monday, August 22, 2011

Tamlic




Tamlic may be available in the countries listed below.


Ingredient matches for Tamlic



Tamsulosin

Tamsulosin hydrochloride (a derivative of Tamsulosin) is reported as an ingredient of Tamlic in the following countries:


  • Italy

International Drug Name Search

Friday, August 19, 2011

Producil




In some countries, this medicine may only be approved for veterinary use.

Ingredient matches for Producil



Efrotomycin

Efrotomycin is reported as an ingredient of Producil in the following countries:


  • United States

International Drug Name Search

Thursday, August 18, 2011

Dolotic


Pronunciation: an-tee-PYE-reen/BEN-zoe-kane
Generic Name: Antipyrine/Benzocaine
Brand Name: Examples include Aurodex and Dolotic


Dolotic is used for:

Relieving pain and inflammation in the ear caused by various conditions. It may be used with antibiotics given by mouth to treat middle ear infections. It may also be used to remove a buildup of earwax.


Dolotic is an analgesic and anesthetic combination. It works by relieving pressure and reducing inflammation, congestion, pain, and discomfort.


Do NOT use Dolotic if:


  • you are allergic to any ingredient in Dolotic or to similar medicines

  • your eardrum is perforated

Contact your doctor or health care provider right away if any of these apply to you.



Before using Dolotic:


Some medical conditions may interact with Dolotic. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

Some MEDICINES MAY INTERACT with Dolotic. However, no specific interactions with Dolotic are known at this time.


Ask your health care provider if Dolotic may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Dolotic:


Use Dolotic as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • For topical use in the ear canal only. Do not get Dolotic in the eyes, nose, or mouth. If you get Dolotic in your eyes, rinse thoroughly with cool water.

  • To use ear drops, lie down or tilt your head so that the affected ear faces up. For adults, gently pull the earlobe up and back to straighten the ear canal. For children, gently pull the earlobe down and back to straighten the ear canal. Drop the medicine into the ear canal. Keep the ear facing up for several minutes so the medicine can run to the bottom of the ear canal. Moisten a clean cotton plug with Dolotic and gently insert into the ear canal to prevent medicine from leaking out.

  • To prevent germs from contaminating the medicine, do not touch the applicator to any surface, including the ear. Do not rinse dropper after use. Keep the container tightly closed.

  • If Dolotic is brown or contains particles, do not use it.

  • If you miss a dose of Dolotic, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Dolotic.



Important safety information:


  • Dolotic may cause harm if it is swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Dolotic while you are pregnant. It is not known if Dolotic is found in breast milk. If you are or will be breast-feeding while you use Dolotic, check with your doctor. Discuss any possible risks to your baby.


Possible side effects of Dolotic:


All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:



Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); irritation not present when you began using Dolotic.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.


See also: Dolotic side effects (in more detail)


If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.


Proper storage of Dolotic:

Store Dolotic at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Protect from freezing. Keep the container tightly closed. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Dolotic out of the reach of children and away from pets.


General information:


  • If you have any questions about Dolotic, please talk with your doctor, pharmacist, or other health care provider.

  • Dolotic is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Dolotic. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Dolotic resources


  • Dolotic Side Effects (in more detail)
  • Dolotic Use in Pregnancy & Breastfeeding
  • Dolotic Support Group
  • 0 Reviews for Dolotic - Add your own review/rating


  • Dolotic Advanced Consumer (Micromedex) - Includes Dosage Information

  • A/B Otic Concise Consumer Information (Cerner Multum)



Compare Dolotic with other medications


  • Ear Wax Impaction
  • Otitis Media

Wednesday, August 17, 2011

Retinol




In some countries, this medicine may only be approved for veterinary use.

Scheme

Rec.INN

ATC (Anatomical Therapeutic Chemical Classification)

D10AD02,R01AX02,S01XA02

CAS registry number (Chemical Abstracts Service)

0000068-26-8

Chemical Formula

C20-H30-O

Molecular Weight

286

Therapeutic Categories

Antiacne agent

Vitamin A

Chemical Name

3,7-dimethyl-9-(2,6,6-trimethyl-1-cyclohexen-1-yl)-2,4,6,8-nonatetraen-1-ol (WHO)

Foreign Names

  • Retinolum (Latin)
  • Retinol (German)
  • Rétinol (French)
  • Retinol (Spanish)

Generic Names

  • Retinol (OS: BAN)
  • Rétinol (OS: DCF)
  • Retinolo (OS: DCIT)
  • Atamin (IS)
  • Axerophtholum (IS)
  • Oleovitamin A (IS)
  • Vitamin A₁ (IS)
  • Vitamin A (PH: BP 2010, USP 32, Ph. Eur. 6)
  • Vitamine A (PH: Ph. Eur. 6)
  • Vitaminum A (PH: Ph. Eur. 6)
  • Retinol Acetate (OS: JAN)
  • Retinyl acetate (IS: INCI)
  • Vitamin A acetate (IS)
  • Retinol Acetate (PH: JP XIV)
  • Retinol Palmiate (OS: JAN)
  • Vitamin A palmitate (IS)
  • Retinol Palmitate (PH: JP XIV)

Brand Names

  • A 313
    Pharmadéveloppement, France


  • AD3 (Retinol and Colecalciferol)
    Krka, Slovenia


  • Adermicina
    Quimica Medical, Argentina


  • Aksoderm
    Gemi, Poland


  • Amenite
    Amenite, Argentina


  • Aquaject A (Retinol and Tocopherol, α- (veterinary use))
    Bayer Animal Health, South Africa


  • Aquasol A
    USV, India


  • Arovit
    Bayer, Italy; Roche, Ethiopia


  • Atomoderma A
    Imvi, Argentina


  • Avibon
    Sanofi-Aventis, France


  • Avicap
    Koçak, Turkey


  • Avigen
    Eras, Turkey


  • A-vitamin Medic
    Medic, Denmark


  • Avitana
    Pfizer, Chile


  • A-Vite
    Neves, Portugal


  • Bagovit A
    Bagó, Argentina


  • Bio Crem A-Bioplix-Biox
    Bioplix-Biox, Peru


  • Carovigen
    Eras, Turkey


  • Cazmar
    Fucus, Argentina


  • Chocola A
    Eisai, Japan; Sannova, Japan


  • Cy Vit (Retinol and Tocopherol, α- (veterinary use))
    Bayer Animal Health, South Africa


  • Davitamon A
    Organon, United Arab Emirates; Organon, Bahrain; Organon, Cyprus; Organon, Egypt; Organon, Iraq; Organon, Iran; Organon, Jordan; Organon, Kuwait; Organon, Lebanon; Organon, Libya; Organon, Qatar; Organon, Saudi Arabia; Organon, Sudan; Organon, Syria; Organon, Yemen


  • Dermamycin (Retinol and Neomycin, + Hydrocortisone, + Lidocaine (veterinary use))
    Alma, Germany


  • Domsedan
    Fortbenton, Argentina


  • Epiteliol
    Medifarma, Peru


  • Eurotretin
    Euroderm, Argentina


  • Evitex (Retinol and Tocopherol)
    Alcon, Italy


  • Flavostat
    Lafedar, Argentina


  • Gramoce A (Retinol and Ascorbic Acid)
    Vir, Spain


  • Hurukus
    Status Salud, Argentina


  • Isee (Retinol and Chloramphenicol (veterinary use))
    Virbac, South Africa


  • Juvela (Retinol and Tocopherol, α-)
    Eisai, Japan; Sannova, Japan


  • Masc Witaminowa ochronna
    Homeofarm, Poland


  • Masc z Witamina A
    Farmina, Poland; Galenowe, Poland


  • Metabolite-A
    Forder, Argentina


  • Microret
    Darier, Mexico


  • Microvit A Prosol (veterinary use)
    Adisseo, Australia


  • Novaquasol (Retinol and Dexpanthenol)
    Minerva, Greece


  • Obervit A (Retinol and Tocopherol, α- (veterinary use))
    Virbac, South Africa


  • Ocean Gold (Retinol and Colecalciferol (veterinary use))
    Bayer Animal Health, South Africa


  • Oculotect
    Novartis, Romania


  • Oral Vit A (Retinol and Tocopherol, α- (veterinary use))
    Virbac, South Africa


  • Ovit-A
    Opsonin, Bangladesh


  • Panvitan (Retinol and Ergocalciferol)
    Takeda, Japan


  • Pro Vit A (Retinol and Tocopherol, α- (veterinary use))
    Virbac, South Africa


  • Retiblan
    Procaps, Colombia


  • Retinol L.CH.
    Chile, Chile


  • Rovigon
    Bayer, Kenya; Bayer, Tanzania; Bayer, Uganda; Bayer, Zambia; Nicholas, India


  • Sahne
    Sannova, Japan


  • Sensivit
    Unimed, Serbia


  • Skinderm A
    Maigal, Argentina


  • Tanvimil A
    Raymos, Argentina


  • Thompson's Vitamin A
    Thompson, New Zealand


  • Vit A Plus (Retinol and Tocopherol, α- (veterinary use))
    Bayer Animal Health, South Africa


  • Vit Aid Vitamin A (Retinol and Tocopherol, α- (veterinary use))
    Afrivet, South Africa


  • Vitamin A
    Egis, Hungary; Health Support Ltd, New Zealand; New Hope Nutrition, New Zealand; Pharco, Romania; Sopharma, Georgia


  • Vitaminas A
    Hasco, Lithuania


  • Vitamine A Dulcis
    Allergan, France


  • Vitamine A Faure
    Europhta, Monaco; Europhta, Tunisia


  • Vitamine A Nepalm
    Nepalm, France


  • Vitamine A
    Opalia, Tunisia


  • Vitaminoftalmina A
    Davi, Portugal


  • Zincaderm (Retinol and Zinc (veterinary use))
    Virbac, France


  • Adisterolo (Retinol and Colecalciferol)
    Abiogen, Italy


  • Animedica K-6 (Retinol and Tocopherol, α- (veterinary use))
    aniMedica, Germany


  • Arovit
    Bayer, Argentina; Bayer, Brazil; Bayer, Colombia


  • Axerophthol
    Biotika, Czech Republic; Biotika, Slovakia


  • Capivit A+E (Retinol and Tocopherol)
    GlaxoSmithKline, Slovenia


  • Eviol-A (Retinol and Tocopherol)
    Gap, Greece


  • Infadolan (Retinol and Ergocalciferol)
    Herbacos, Slovakia


  • Microvit A Supra (veterinary use)
    Adisseo, Australia


  • Microvit AD3 Supra (Retinol and Cobalamin (veterinary use))
    Adisseo, Australia


  • Rinocusi Vitaminico
    Sanofi-Aventis S.A., Spain


  • Rinovitex
    Alcon, Spain


  • Sicovit A
    Sicomed, Romania


  • Vit A N
    Farmigea, Italy


  • Vitamin A Kimia Farma
    Kimia Farma, Indonesia


  • Vitamin A Slovakofarma
    Slovakofarma, Czech Republic; Zentiva, Slovakia


  • Vitamin AD Slovakopharma (Retinol and Ergocalciferol)
    Zentiva, Slovakia


  • Vitamina A
    Arion, Peru; Biofarm, Romania; MD&D International, Peru; Sunshine, Peru


  • Vitamuruine
    Medgenix, Belgium; Medgenix, Luxembourg


  • A Grin
    Grin, Mexico


  • Acon
    Sanofi-Aventis, Costa Rica; Sanofi-Aventis, Dominican Republic; Sanofi-Aventis, Guatemala; Sanofi-Aventis, Honduras; Sanofi-Aventis, Mexico; Sanofi-Aventis, Nicaragua; Sanofi-Aventis, Panama; Sanofi-Aventis, El Salvador


  • A-Forte
    Globe, Bangladesh


  • Alfa-Mon
    Biotech, Venezuela


  • Aquasol A
    Hospira, United States


  • Aquavit
    USV, Sri Lanka


  • Arovit
    Bayer, Brazil; Bayer, Chile; Bayer, Ecuador; Bayer, India; Bayer, Peru; Bayer Animal Health, Luxembourg; Roche, Oman


  • Augenschutz-Kapseln
    Salus, Germany


  • Auxina A Masiva
    Chiesi, Spain


  • Auxina A+E (Retinol and Tocopherol)
    Chiesi, Spain


  • A-Vita
    Leiras, Finland


  • A-vitel
    Medipharma, Argentina


  • A-Viton
    Kahira, Oman


  • Bagovit-A
    Bago, Chile; Bagó, Costa Rica; Bagó, Dominican Republic; Bagó, Guatemala; Bagó, Honduras; Bagó, Nicaragua; Bagó, Panama; Bagó, El Salvador


  • Bio Crem A
    Bios, Peru


  • Biominol A D Hidrosoluble (Retinol and Ergocalciferol)
    Alter, Spain


  • Biominol A Hidrosoluble
    Alter, Spain


  • Bruvita
    Bruluart, Mexico


  • Burgerstein Vitamin A
    Antistress, Switzerland


  • Chemivita Vitamin A Cream
    Multichem, New Zealand


  • Chocola A
    Eisai, Japan; Sannova, Japan


  • Coldistop (Retinol and Tocopherol, α-)
    ProReo Pharma, Switzerland; Sigmapharm, Austria


  • Dakrina
    Akorn, Peru


  • Dermalife (Vitamin A)
    Orion, New Zealand


  • Dermosavit
    Coel, Poland


  • Dermotin "A"
    Mex-América, Mexico


  • Dermovit A
    Coel, Poland


  • Evitex A + E (Retinol and Tocopherol)
    Alcon, Spain


  • Fiosen-A
    Cosmetica, Argentina


  • Gerogelat (Retinol and Tocopherol, α-)
    Kwizda, Austria


  • Hypotears Gel
    Ciba Vision, Slovakia; Medis, Slovenia; Novartis, Bangladesh; Novartis, Philippines; Novartis Ophtalmics, Czech Republic; Novartis Ophthalmics, Sri Lanka


  • Masc Ochronna z Witamina A
    Hasco, Poland


  • Masivol
    Valeant, Argentina


  • Neo Cutigenol (Retinol and Chlorhexidine)
    Nycomed, Belgium


  • Oculotect
    Novartis, Switzerland; Novartis, China; Novartis, Germany; Novartis, Luxembourg; Novartis, Poland; Novartis Ophthalmics, Hungary; Novartis Ophthalmics, Vietnam


  • Oculotect (Retinol and Carbomer)
    Novartis, Indonesia


  • Oculotect (Retinol and Hypromellose)
    Novartis, Germany


  • Oleovit
    Fresenius Kabi, Austria


  • Piktum
    Medicom, Slovakia


  • Ratinol
    Drug International, Bangladesh


  • Retinol
    Hersil, Peru


  • Retiva
    Vivax, Venezuela


  • Ro-A-Vit
    Bayer, Kenya; Bayer, Tanzania; Bayer, Uganda; Bayer, Zambia


  • Rovigon (Retinol and Tocopherol)
    Bayer, Belgium; Roche, Oman


  • Solan-M
    Winzer, Germany


  • Tetra (veterinary use)
    Anivite - Alimentação Racional para Animais, SA, Portugal


  • Tokovit A+E (Retinol and Tocopherol)
    Hasco, Poland


  • Trigantol (Retinol and Tocopherol, α-, + Colecalciferol (veterinary use))
    Bayer Tiergesundheit, Austria


  • Ungvita
    Bayer, New Zealand; Bayer Consumer Care, Australia


  • Univit-A
    United Pharmaceutical, United Arab Emirates; United Pharmaceutical, Bahrain; United Pharmaceutical, Iraq; United Pharmaceutical, Jordan; United Pharmaceutical, Libya; United Pharmaceutical, Qatar; United Pharmaceutical, Saudi Arabia; United Pharmaceutical, Sudan; United Pharmaceutical, Yemen


  • Vetramycin Injektoren (Retinol and Penicillin G Procaine, + Dihydrostreptomycin, + Calcium Pantothenate (veterinary use))
    Alvetra u. Werfft, Austria


  • Viadrops (veterinary use)
    Ceva, Netherlands


  • Vicomin A C (Retinol and Ascorbic Acid)
    Chefaro, Spain


  • Vitafluid
    Mann, Germany


  • Vitagel
    Mann, Germany


  • Vitamin A "Blache"
    Bausch & Lomb Swiss, Switzerland


  • Vitamin A Bioextra
    Bioextra, Hungary


  • Vitamin A Jenapharm
    Mibe Jena, Germany


  • Vitamin A Streuli
    Streuli Pharma, Switzerland


  • Vitamin A+E Hevert (Retinol and Tocopherol, α-)
    Hevert, Germany


  • Vitamin A
    Pharco, Oman; Phebra, Australia; PSM, New Zealand; Synteza, Poland


  • Vitamin A (veterinary use)
    Vetsearch International, Australia


  • Vitamin AD3E Graeub (Retinol and Colecalciferol, + Tocopherol, α- (veterinary use))
    Animedica, Austria


  • Vitamin AD3EC Ogris (Retinol and Colecalciferol, Tocopherol, α-, + Ascorbic Acid (veterinary use))
    Ogris, Austria


  • Vitamin A-POS
    Biem, Turkey


  • Vitamina A
    Eicopen, Venezuela; Kimiceg, Venezuela; Naturissima, Venezuela; Sigma, Argentina; Ursapharm, Czech Republic; Vivax, Venezuela


  • Vitamin-A-saar
    MIP, Germany


  • Vitaminum A
    Gal, Poland; GlaxoSmithKline, Poland; Hasco, Poland; Lek, Latvia; Medana, Poland


  • VitA-POS
    Pharma Medica, Switzerland; Ursapharm, Russian Federation


  • Vitasol A-D3-E (Retinol and Colecalciferol, + Tocopherol, α- (veterinary use))
    Richter, Austria


  • Vitasol AD3EC (Retinol and Colecalciferol, + Tocopherol, α-, Ascorbic Acid (veterinary use))
    Richter, Austria


  • Microvit A DLC (veterinary use)
    Adisseo, Australia


  • Vitamine A (veterinary use)
    Eurovet, Netherlands

International Drug Name Search

Glossary

BANBritish Approved Name
DCFDénomination Commune Française
DCITDenominazione Comune Italiana
ISInofficial Synonym
JANJapanese Accepted Name
OSOfficial Synonym
PHPharmacopoeia Name
Rec.INNRecommended International Nonproprietary Name (World Health Organization)
WHOWorld Health Organization

Click for further information on drug naming conventions and International Nonproprietary Names.

Sunday, August 14, 2011

Dantrium


Generic Name: Dantrolene Sodium
Class: Direct-acting Skeletal Muscle Relaxants
VA Class: MS200
CAS Number: 24868-20-0


  • Hepatic Effects of Oral Dantrolene


  • Risk of developing potentially fatal, hepatic injury (e.g., hepatitis); should not be used for unlabeled indications.109




  • Females, patients >35 years of age, and those receiving other drugs (especially estrogens) concomitantly are at greatest risk.109




  • Risk of symptomatic hepatitis (fatal and nonfatal) may be dose dependent; incidence much higher at dosages ≥800 mg daily than at dosages ≤400 mg daily.109 Even intermittent, short courses at higher dosages associated with increased risk.109 Use lowest possible effective dose.109




  • Overt hepatitis most frequently observed between 3rd and 12th month of therapy.109




  • Frequently monitor hepatic function.109 (See Hepatic Effects under Cautions.)




  • If benefits are not evident within 45 days, discontinue therapy.109




Introduction

Skeletal muscle relaxant.108 109


Uses for Dantrium


Spasticity


Oral management of spasticity resulting from upper motor neuron disorders (e.g., multiple sclerosis, cerebral palsy, spinal cord injury, stroke syndrome).109


Ineffective in the treatment of amyotrophic lateral sclerosis (ALS).a


Not indicated for the treatment of muscle spasms resulting from rheumatic disorders or musculoskeletal trauma.109 a


Malignant Hyperthermia Crisis


IV treatment of fulminant hypermetabolism of skeletal muscle that is characteristic of malignant hyperthermia crisis;108 should be used with and not as a substitute for supportive measures.a


Preoperative and postoperative prevention or attenuation of malignant hyperthermia in susceptible individuals; used orally or IV (when oral therapy is not practical or feasible).108 109


Neuroleptic Malignant Syndrome


Has been used for the treatment of neuroleptic malignant syndrome; fatalities reported despite therapy with the drug.108 109


Dantrium Dosage and Administration


General


  • Spasticity


  • Establish therapeutic goal before initiating therapy.109 Use lowest possible effective dosage.109 Discontinue drug if beneficial effects are not attained within 45 days.109 (See Boxed Warning.)




  • Subjective impressions of improvement may sometimes be confirmed by withdrawal of the drug for 2–4 days.109



  • Malignant Hyperthermia Crisis


  • Immediately discontinue all anesthetic agents and institute IV dantrolene as soon as malignant hyperthermia crisis is recognized.108




  • Monitor vital signs; employ the usual precautions associated with surgery in susceptible patients, since malignant hyperthermia may only be attenuated rather than prevented.108



Administration


Administer orally or by continuous IV infusion or rapid IV injection.108 109


Oral Administration


Administer orally 1–4 times daily.109


Extemporaneous Suspension

To prepare oral suspension containing 25 mg of dantrolene sodium per 5 mL, empty 5 100-mg capsules in 50 mL of Syrup NF, then add a solution containing 150 mg of citric acid in 10 mL of water followed by a sufficient volume of Syrup NF to make 100 mL.c Mix thoroughly before use.c


IV Administration


For solution compatibility information, see Compatibility under Stability.


For IV infusion, transfer reconstituted solution from the appropriate number of vials to plastic infusion bag.109 Do not use large glass containers; precipitate formation observed with some glass containers.108


Avoid extravasation (injection has high pH).108


Reconstitution

Add 60 mL of sterile water for injection (without bacteriostatic agent) to vial containing 20 mg of dantrolene sodium.108 Shake vial until solution is clear.108


Although reconstituted solutions are stable for 6 hours,108 infusions preferably should be prepared immediately before use.a


Rate of Administration

Preoperative prophylaxis: Infuse IV over approximately 1 hour beginning about 1.25 hours before anticipated anesthesia.108


Treatment of malignant hyperthermia syndrome: Rapid IV injection.108


Dosage


Available as dantrolene sodium; dosage expressed in terms of the salt.108 109


Pediatric Patients


Spasticity

Oral

Children ≥5 years of age: 0.5 mg/kg once daily for 7 days, followed by 0.5 mg/kg 3 times daily for 7 days, then 1 mg/kg 3 times daily for 7 days, and then 2 mg/kg 3 times daily, if necessary.109 Some patients may require doses 4 times daily.109


If no additional benefit is observed at the next higher dosage, decrease dosage to the previous (lower) dosage.109


Malignant Hyperthermia Crisis

Preoperative Prophylaxis

Oral

4–8 mg/kg daily in 3 or 4 divided doses for 1–2 days prior to surgery; give the last dose approximately 3–4 hours before surgery with small amount of water.109


IV

2.5 mg/kg infused over approximately 1 hour beginning about 1.25 hours before anticipated anesthesia; may give additional individualized doses intraoperatively, if necessary.108


Treatment

IV

Initially, 1 mg/kg or more by rapid IV injection.108 Repeat dose as necessary until physiologic and metabolic abnormalities subside or a maximum total dosage of 10 mg/kg is reached.108


Average total dosage: 2.5 mg/kg.a


Repeat regimen if physiologic and metabolic abnormalities reappear.108


Post-crisis Follow-up

Oral

4–8 mg/kg daily in 4 divided doses for up to 3 days after the crisis.109


IV

Initially, 1 mg/kg or more as clinically indicated.108 Individualize subsequent doses.108


Adults


Spasticity

Oral

Initially, 25 mg once daily for 7 days, followed by 25 mg 3 times daily for 7 days, then 50 mg 3 times daily for 7 days, and then 100 mg 3 times daily, if necessary.109 Some patients may require doses 4 times daily.109


If no additional benefit is observed at the next higher dosage, decrease dosage to the previous (lower) dosage.109


Malignant Hyperthermia Crisis

Preoperative Prophylaxis

Oral

4–8 mg/kg daily in 3 or 4 divided doses for 1–2 days prior to surgery; give the last dose approximately 3–4 hours before surgery with small amount of water.109


IV

2.5 mg/kg infused over approximately 1 hour beginning about 1.25 hours before anticipated anesthesia; may give additional individualized doses intraoperatively, if necessary.108


Treatment

IV

Initially, 1 mg/kg or more by rapid IV injection.108 Repeat dose as necessary until physiologic and metabolic abnormalities subside or a maximum total dosage of 10 mg/kg is reached.108


Average total dosage: 2.5 mg/kg.a


Repeat regimen if physiologic and metabolic abnormalities reappear.108


Post-crisis Follow-up

Oral

4–8 mg/kg daily in 4 divided doses for up to 3 days after the crisis.109


IV

Initially, 1 mg/kg or more as clinically indicated.108 Individualize subsequent doses.108


Prescribing Limits


Pediatric Patients


Spasticity

Oral

Maximum 100 mg 4 times daily.109


Malignant Hyperthermia Crisis

Treatment

IV

Maximum 10 mg/kg.108


Adults


Spasticity

Oral

Maximum 100 mg 4 times daily.109


Malignant Hyperthermia Crisis

Treatment

IV

Maximum 10 mg/kg.108


Cautions for Dantrium


Contraindications



  • Oral dantrolene contraindicated in patients with active hepatic disease (e.g., hepatitis, cirrhosis).109




  • Also contraindicated in patients who must utilize spasticity to maintain upright posture and balance in moving or to obtain or maintain increased body function.109




  • No contraindications to IV dantrolene for prophylaxis or management of malignant hyperthermia crisis.108



Warnings/Precautions


Warnings


Hepatic Effects

Fatal and nonfatal hepatic disorders of idiosyncratic or hypersensitivity type possible with oral dantrolene.108 109 (See Boxed Warning.)


Obtain serum AST, ALT, alkaline phosphatase, and total bilirubin concentrations prior to and periodically during therapy or whenever symptoms of hepatitis occur.109


If liver function test abnormalities occur alone, consider discontinuing therapy; continue or reinstitute the drug only if major benefits occurred during dantrolene therapy.109


If symptoms of hepatitis are accompanied by liver function test abnormalities or jaundice, discontinue dantrolene.109


Following discontinuance for clinical and/or laboratory evidence of hepatotoxicity, reinstitute dantrolene only in patients who clearly need the drug and only after symptoms and laboratory abnormalities of hepatotoxicity have resolved.109 Hospitalize patient to reinitiate therapy with very small doses; gradually increase dosage with frequent monitoring of liver function; discontinue drug immediately if signs of liver abnormality recur.109


Risks Associated with Long-term, Chronic Use

Long-term safety in humans yet to be established.109


Nephropathy, benign and malignant mammary and testicular tumors, hepatic lymphangiomas, and hepatic angiosarcomas reported following long-term use in animals; assess risk/benefits of chronic administration.109


Sensitivity Reactions


Photosensitivity

Possible photosensitivity reactions; limit exposure to sunlight.109


General Precautions


CNS Depression

Performance of activities requiring mental alertness may be impaired.108 109


Concurrent use of other CNS depressants may potentiate CNS depression.108 109 (See Specific Drugs under Interactions.)


Mannitol Content

If mannitol is used for the prevention or treatment of late renal complications of malignant hyperthermia, consider mannitol in the IV dantrolene formulation (3 g of mannitol per 20-mg vial) as part of the total amount administered.108


Concomitant Illnesses

Use with caution in patients with severe cardiac impairment secondary to myocardial disease or with impaired pulmonary function (particularly obstructive pulmonary disease).109


Specific Populations


Pregnancy

Category C.108 109


Readily crosses the placenta.108 (See Distribution under Pharmacokinetics.)


Lactation

Distributed into milk;b use of oral dantrolene not recommended.109


Pediatric Use

Long-term safety of oral dantrolene not established in children <5 years of age.109


Weigh possible risks against potential benefits before initiating long-term oral therapy; adverse effects may become evident only after many years.109


Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults.108


Titrate dosage carefully.108


Hepatic Impairment

Use with caution in patients with a history of hepatic impairment.109


Common Adverse Effects


Muscle weakness, drowsiness, dizziness, lightheadedness, diarrhea, nausea, malaise, fatigue.a 109


Interactions for Dantrium


Metabolized in the liver, but the precise enzymes responsible are unknown.108


Drugs Affecting Hepatic Microsomal Enzymes


Pharmacokinetic interaction with CYP enzyme inducers theoretically possible.108


Specific Drugs




































Drug



Interaction



Comment



Calcium-channel blockers (e.g., verapamil)



Cardiovascular collapse reported rarely108



Concomitant use during malignant hyperthermia crisis not recommended108



Clofibrate



Decreased binding of dantrolene to plasma proteins108



CNS depressants



Possible additive CNS effects (e.g., dizziness)108 109



Use with caution108 109



Diazepam



Additive sedative effect; dantrolene metabolism and protein binding unaffacted108



Use with cautiona



Estrogens



Possible increased frequency of hepatotoxicity in women >35 years of age109



Potential for interaction not clearly established; use with caution109



Phenobarbital



Pharmacokinetic interaction unlikely; dantrolene metabolism unaffected108



Phenytoin



No change in binding of dantrolene to plasma proteins108



Tolbutamide



Increased binding of dantrolene to plasma proteins108



Vecuronium



Potentiation of vecuronium-induced neuromuscular blockade108



Warfarin



Decreased binding of dantrolene to plasma proteins108


Dantrium Pharmacokinetics


Absorption


Bioavailability


Absorption following oral administration is incomplete and slow but consistent.109


Distribution


Extent


Readily crosses the placenta, with maternal and fetal whole blood concentrations approximately equal at delivery; neonatal concentrations then fall approximately 50% per day for 2 days before declining sharply.108


Plasma Protein Binding


Substantially bound to plasma proteins (mostly albumin); binding is readily reversible.108


Elimination


Metabolism


Specific metabolic pathways not established.108 May undergo hydrolysis and subsequent oxidation forming nitrophenylfuroic acid.108


Elimination Route


Specific pathways not established.108


Half-life


Approximately 4–8 hours following IV administration.108


Approximately 9 hours following oral administration in adults.109


Stability


Storage


Oral


Capsules

<40°C.109


Parenteral


Powder for Injection

15–30°C.108 Avoid prolonged exposure to light.108


Store reconstituted solutions at 15–30°C for up to 6 hours.108 Protect from light.108


Compatibility


For information on systemic interactions resulting from concomitant use, see Interactions.


Parenteral


Solution Compatibility108





Incompatible



Dextrose 5% in water



Sodium chloride 0.9%


ActionsActions



  • Causes skeletal muscle relaxation through a direct effect on skeletal muscle, probably by interfering with release of calcium from the sarcoplasmic reticulum.108 109




  • Interference with calcium release from the sarcoplasmic reticulum may prevent the increase in myoplasmic calcium that activates acute catabolism of skeletal muscle cells in patients with anesthesia-induced malignant hyperthermia.108




  • Has little or no effect on the contraction of cardiac or intestinal smooth muscle, except possibly at concentrations higher than those required for effects on skeletal muscle contraction.a



Advice to Patients



  • Risk of hepatoxicity with oral dantrolene.108 109




  • Risk of dizziness and muscle weakness; use caution when driving or operating machinery.108 109 Do not drive or operate machinery within 48 hours of receiving IV dantrolene.109




  • Risk of choking and difficulty swallowing; exercise caution during meals.108




  • Risk of photosensitivity reactions; limit exposure to sunlight.109




  • Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.108 109




  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, alcohol consumption, and any concomitant illnesses.108 109




  • Importance of informing patients of other important precautionary information.108 109 (See Cautions.)



Preparations


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.


* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name











































Dantrolene Sodium

Routes



Dosage Forms



Strengths



Brand Names



Manufacturer



Oral



Capsules



25 mg*



Dantrium



Procter & Gamble



Dantrolene Sodium Capsules



Amide, Global



50 mg*



Dantrium



Procter & Gamble



Dantrolene Sodium Capsules



Amide, Global



100 mg*



Dantrium



Procter & Gamble



Dantrolene Sodium Capsules



Amide, Global



Parenteral



For injection



20 mg



Dantrium Intravenous (with mannitol 3 g)



Procter & Gamble


Comparative Pricing


This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.


Dantrium 100MG Capsules (JHP PHARMACEUTICALS): 45/$99.99 or 135/$291.99


Dantrium 25MG Capsules (JHP PHARMACEUTICALS): 45/$58.98 or 135/$164.96


Dantrium 50MG Capsules (JHP PHARMACEUTICALS): 45/$81.99 or 135/$234.97


Dantrolene Sodium 100MG Capsules (GLOBAL PHARMACEUTICAL CORP): 45/$76.99 or 135/$219.97


Dantrolene Sodium 25MG Capsules (GLOBAL PHARMACEUTICAL CORP): 30/$34.99 or 90/$81.97


Dantrolene Sodium 50MG Capsules (GLOBAL PHARMACEUTICAL CORP): 45/$63.99 or 135/$175.97



Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.


The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.


† Use is not currently included in the labeling approved by the US Food and Drug Administration.




References


Only references cited for selected revisions after 1984 are available electronically.



100. Coons DJ, Hillman FJ, Marshall RW. Treatment of neuroleptic malignant syndrome with dantrolene sodium: a case report. Am J Psychiatry. 1982; 139:944-5. [IDIS 154797] [PubMed 6124135]



101. Goekoop JG, Carbaat PAT. Treatment of neuroleptic malignant syndrome with dantrolene. Lancet. 1982; 2:49-50.



102. May DC, Morris SW, Stewart RM et al. Neuroleptic malignant syndrome: response to dantrolene sodium. Ann Intern Med. 1983; 98:183-4. [IDIS 164929] [PubMed 6824251]



103. Daoudal P, Delacour JL. Treatment of neuroleptic malignant syndrome with dantrolene. Lancet. 1982; 2:217. [PubMed 6123917]



104. Granato JE, Stern BJ, Ringel A et al. Neuroleptic malignant syndrome: successful treatment with dantrolene and bromocriptine. Ann Neurol. 1983; 14:89-90. [IDIS 173103] [PubMed 6614876]



105. Goulon M, de Rohan-Chabot P, Elkharrat D et al. Beneficial effects of dantrolene in the treatment of neuroleptic malignant syndrome: a report of the two cases. Neurology. 1983; 33:516-8. [IDIS 169146] [PubMed 6682201]



106. Rappaport PL. Extemporaneous dosage preparations for pediatrics. Can J Hosp Pharm. 1983; 36:66-70,74. [PubMed 10262678]



107. Kaplan RF, Feinglass NG, Webster W et al. Phenelzine overdose treated with dantrolene sodium. JAMA. 1986; 255:642-4. [IDIS 210184] [PubMed 3944965]



108. Procter & Gamble Pharmaceuticals. Dantrium IV (dantrolene sodium) for injection prescribing information. Cincinnati, OH; 2001 May.



109. Procter & Gamble Pharmaceuticals. Dantrium (dantrolene sodium) capsules prescribing information. Cincinnati, OH; 1997 Feb.



110. Rubin AS, Zablocki AD. Hyperkalemia, verapamil, and dantrolene. Anesthesiology. 1987; 66:246-9. [IDIS 227329] [PubMed 3813090]



111. Dantrolene (Dantrium) interactions: verapamil (e.g., Calan). In: Hansten PD, Horn JR. Hansten and Horn’s drug interactions, analysis and managements. St. Louis, MO. Facts and Comparisons; 2002:450a.



a. AHFS drug information 2003. McEvoy GK, ed. Dantrolene. Bethesda, MD: American Society of Health-System Pharmacists; 2003:1321-5.



b. Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and lactation. 6th ed. Baltimore, MD: Williams & Wilkins; 2002:364-6.



c. Nahata MC, Hipple TF. Pediatric drug formulations. 4th ed. Cincinnati, Ohio: Harvey Whitney Books Company; 2000: 35.



More Dantrium resources


  • Dantrium Side Effects (in more detail)
  • Dantrium Use in Pregnancy & Breastfeeding
  • Drug Images
  • Dantrium Drug Interactions
  • Dantrium Support Group
  • 2 Reviews for Dantrium - Add your own review/rating


  • Dantrium Prescribing Information (FDA)

  • Dantrium MedFacts Consumer Leaflet (Wolters Kluwer)

  • Dantrium Concise Consumer Information (Cerner Multum)

  • Dantrium Advanced Consumer (Micromedex) - Includes Dosage Information

  • Dantrolene Prescribing Information (FDA)

  • Dantrium Intravenous Prescribing Information (FDA)

  • Dantrium Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information



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