Dantrolene dosage

Baclofen is at least as effective as diazepam in reducing spasticity and causes less sedation. In addition, baclofen does not reduce overall muscle strength as much as dantrolene. It is rapidly and completely absorbed after oral administration and has a plasma half-life of 3-4 hours. Dosage is started at 15 mg twice daily, increasing as tolerated to 100 mg daily. Adverse effects of this drug include drowsiness however, patients become tolerant to the sedative effect with chronic administration. Increased seizure activity has been reported in epileptic patients. Therefore, withdrawal from baclofen must be done very slowly. 

Clinical trials with oral tizanidine report comparable efficacy in relieving muscle spasm to diazepam, baclofen, and dantrolene. However, tizanidine produces a different spectrum of adverse effects, including drowsiness, hypotension, dry mouth, and asthenia. The dosage requirements vary markedly among patients, and individual dosage titration is necessary to achieve an optimal clinical effect. 

Dantrolene sodium (Dantrium] Adult 25 mg/d initially increase up to 100 mg 2, 3, or 4 times per day as needed maximum recommended dose is 400 mg/day. Children (older than 5 yr of age] initially, 0.5 mg/kg body weight BID increase total daily dosage by 0.5 mg/kg every 4-7 days as needed, and give total daily amount in 4 divided dosages maximum recommended dose is 400 mg/d. Exerts an effect directly on the muscle cell may cause generalized weakness in all skeletal musculature. 

The absorption of oral dantrolene can be significantly increased by metoclopramide (15). As the risk of hepatotoxicity has been related to the dosage of dantrolene, increased clinical surveillance is necessary to avoid toxicity of dantrolene during concurrent treatment with metoclopramide. 

Memantine might modify the effects of antispasmodic drugs such as dantrolene or baclofen and dosage adjustment might be required. ... 

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