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Ryanodex (dantrolene) Disease Interactions

There are 3 disease interactions with Ryanodex (dantrolene):

Major

Dantrolene (Includes Ryanodex) ↔ Hepatotoxicity

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

The use of dantrolene is contraindicated in patients with active liver disease such as hepatitis and cirrhosis. Symptomatic hepatitis, occasionally fatal, has been reported at various dosage levels of the drug. However, the risk at dosages up to 400 mg/day appears to be much lower than that at 800 mg/day or more. Other risk factors may include female gender, age over 35 years, and use of concomitant medications (e.g., estrogens). Both asymptomatic liver enzyme elevations as well as overt hepatitis have occurred following dantrolene exposures of varying duration, although the latter most frequently has been observed between the third and twelfth month of therapy. All patients treated with dantrolene should have liver function tests (ALT, AST, alkaline phosphatase, total bilirubin) performed at baseline and regularly thereafter. Discontinuation of therapy should be considered if liver enzymes are significantly elevated. The drug should be withdrawn promptly, however, if laboratory abnormalities are accompanied by symptoms of hepatic injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. Following complete recovery, reinstitution of dantrolene therapy is generally not recommended except in those patients who clearly benefit from the medication. Any attempt to restart treatment should occur in the hospital with low initial dosages, gradual increases, and frequent monitoring.

References

  1. Wilkinson SP, Portmann B, Williams R "Hepatitis from dantrolene sodium." Gut 20 (1979): 33-6
  2. Chan CH "Dantrolene sodium and hepatic injury." Neurology 40 (1990): 1427-32
  3. "Product Information. Dantrium (dantrolene)." Procter and Gamble Pharmaceutic, Cincinnati, OH.
View all 4 references
Moderate

Dantrolene (Includes Ryanodex) ↔ Cardiac Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Heart Disease

Pericarditis, both with and without pleural effusion, has occasionally occurred during the long-term administration of dantrolene. It has not been reported with intravenous use in the emergency treatment of malignant hyperthermia crises. Other adverse cardiovascular effects include tachycardia, erratic blood pressure, and heart failure. Prolonged therapy with dantrolene should be administered cautiously in patients with significantly impaired cardiac function, especially if due to myocardial disease.

References

  1. "Product Information. Dantrium (dantrolene)." Procter and Gamble Pharmaceutic, Cincinnati, OH.
  2. Petusevsky ML, Faling LJ, Rocklin RE, Snider GL, Merliss AD, Moses JM, Dorman SA "Pleuropericardial reaction to treatment with dantrolene." JAMA 242 (1979): 2772-4
Moderate

Dantrolene (Includes Ryanodex) ↔ Pulmonary Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment

Dantrolene may cause respiratory depression that is possibly related to the muscle weakness produced by the drug. Pleural effusion associated with pericarditis has also occurred occasionally during the long-term administration of dantrolene. Therapy with dantrolene should be administered cautiously in patients with impaired pulmonary function, particularly that due to obstructive pulmonary disease. Patients who receive intravenous dantrolene should have vital signs monitored.

References

  1. Miller DH, Haas LF "Pneumonitis with dantrolene." J Neurol Neurosurg Psychiatry 47 (1984): 553-4
  2. "Product Information. Dantrium (dantrolene)." Procter and Gamble Pharmaceutic, Cincinnati, OH.
  3. Petusevsky ML, Faling LJ, Rocklin RE, Snider GL, Merliss AD, Moses JM, Dorman SA "Pleuropericardial reaction to treatment with dantrolene." JAMA 242 (1979): 2772-4

Ryanodex (dantrolene) drug Interactions

There are 600 drug interactions with Ryanodex (dantrolene)

Ryanodex (dantrolene) alcohol/food Interactions

There is 1 alcohol/food interaction with Ryanodex (dantrolene)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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