Dosing and administration in an mh crisis7
Required supportive measures
In addition to treatment with RYANODEX®, institute the following supportive measures:
- Discontinue use of MH-triggering anesthetic agents (eg, volatile anesthetic gases and succinylcholine)7
- Manage metabolic acidosis7
- Institute cooling as necessary7
- Maintain adequate diuresis as needed7
Administer RYANODEX® by intravenous push at a minimum dose of 1 mg/kg. If the physiologic and metabolic abnormalities of MH continue, administer additional intravenous boluses up to the maximum cumulative dosage of 10 mg/kg.
Dosage in the event of MH relapse7
If the physiologic and metabolic abnormalities reappear, repeat RYANODEX® dosing by intravenous push starting with 1 mg/kg.*
Dosage for prevention of malignant hyperthermia7
The recommended prophylactic dose of RYANODEX® is 2.5 mg/kg administered intravenously over a period of at least 1 minute, starting approximately 75 minutes prior to surgery. Avoid agents that trigger MH.
Precautions should be taken when administering RYANODEX® preoperatively for the prevention of malignant hyperthermia, including monitoring vital signs, avoiding known triggering agents, and monitoring for early clinical and metabolic signs of malignant hyperthermia that may indicate additional treatment is needed.
If surgery is prolonged, administer additional individualized RYANODEX® doses during anesthesia and surgery.
Dosage for pediatric patients7
The recommended weight-based dose of RYANODEX® for pediatric patients in the treatment and prevention of MH is the same as for adults for these indications.7
*Malignant Hyperthermia Association of the United States (MHAUS) recommends initial and repeat treatment doses of 2.5 mg/kg.8