Malignant Hyperthermia Medication

Updated: Jul 24, 2020
  • Author: James W Chapin, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.


Skeletal Muscle Relaxants

Class Summary

These agents may be helpful in the treatment of malignant hyperthermia (MH).

Dantrolene sodium (Dantrium, Revonto)

Indications for treatment of malignant hyperthermia with dantrolene include signs of hypermetabolism, a rapid rise in carbon dioxide in the face of an increase in minute ventilation, tachycardia, muscle and/or jaw rigidity (after succinylcholine), and fever (a late sign).

Dantrolene may work by reducing or preventing the increase in myoplasmic calcium ion concentration responsible for activating the catabolic processes associated with malignant hyperthermia.

The initial dose is 2.5 mg/kg, repeated every 5 minutes until reversal of the reaction occurs or a total dose of 10 mg/kg (or 20 mg/kg, according to some practitioners) is reached. If there is no clinical response, another diagnosis should be considered.