(FDA approved in bold)

• Chronic spasticity
  
• Malignant hyperthermia (MT)
  
• Exercise-induced muscle pain
  
• Heat stroke
  
• Neuroleptic malignant syndrome

• Dantrolene produces relaxation by interfering with the release of calcium from the sarcoplasmic reticulum, weakening muscle contraction, and reversing the hypermetabolic process of MT

• Pain – hours-days

• Discontinue use once MT symptoms remit. For chronic spasticity, continue to use with standard precautions

• For spasticity, increase to highest tolerated dose. If ineffective, stop after 45 days and consider alternative treatments. In MT cases, stop all anesthetics

• For focal spasticity, i.e., post-stroke spasticity, botulinum toxin is often more effective and is better tolerated
  
• Use other centrally acting muscle relaxants with caution due to potential synergistic CNS depressant effect
  
• 100% oxygen, cold gastric lavage, cooling blankets, and cold intravenous fluids may be useful in MT

• Obtain baseline liver function studies then do periodically