Treatment using dantrolene
Provided are low-volume, safe for injection formulations of dantrolene yielding significant advantages over the currently approved and marketed dantrolene for malignant hyperthermia (MH) threatening anesthetic crisis. Once dantrolene can be made immediately available to patients triggered of MH, the anesthesiologist will be able to focus exclusively on the management of the patient's physiologic status in this complex and evolving crisis, not on the laborious and time consuming reconstitution process of the rescue agent. The low volume, safe for injection formulations of dantrolene have significant advantages over currently used approaches to the prevention and treatment of pumphead, and other neurological, cognitive and motor dysfunction incident to iatrogenically or trauma induced situations of altered blood flow, including those incurred during surgical procedures involving CPB or related procedures, as well as those incurred during non-normothermic episodes caused iatrogenically or by disease.
1. A method of treating a non-normothermic state associated with recreational drug use in a mammal, comprising the step of: intravenously administering to a mammal in need of treatment for a non-normothermic state associated with recreational drug use a therapeutically effective amount of a safe for injection, liquid formulation comprising:
dantrolene sodium at a concentration in the range of 3.33 mg/ml to 166.67 mg/ml;
a water-soluble polysorbate;
a compound selected from the group consisting of sorbitol and mannitol; and
water as a liquid carrier,
wherein said dantrolene sodium and water are present together as a colloidal dispersion of dantrolene sodium particles in the water, wherein the dantrolene sodium particles are less than about 2 microns in average diameter, and wherein the formulation is safe for intravenous administration.
2. The method of claim 1 , wherein the concentration of the dantrolene is in the range of 30-80 mg/ml or 10-60 mg/ml.
3. The method of claim 1 , wherein the amount of dantrolene administered to the patient is from 0.1 to 10 mg/kg.
4. The method of claim 3 , wherein the amount of dantrolene administered to the patient is from 0.5 to 4 mg/kg.
5. The method of claim 4 , wherein the amount of dantrolene administered to the patient is 1 mg/kg.
6. The method of claim 1 , wherein the recreational drug is ecstasy.
7. The method of claim 1 , wherein the recreational drug is LSD or a psychedelic drug.
8. The method of claim 1 , wherein the formulation consists essentially of: dantrolene sodium at a concentration in the range of 3.33 mg/ml to 166.67 mg/ml; a water-soluble polysorbate; a compound selected from the group consisting of sorbitol and mannitol: and water as a liquid carrier, wherein said dantrolene sodium and water are present together as a colloidal dispersion of dantrolene sodium particles in the water, wherein the dantrolene sodium particles are less than about 2 microns in average diameter, and wherein the formulation is safe for intravenous administration.
9. The method of claim 1 , wherein the formulation further comprises polyvinylpyrrolidone (PVP).
10. The method of claim 1 , wherein the formulation consists essentially of: dantrolene sodium at a concentration in the range of 3.33 mg/ml to 166.67 mg/ml; a water-soluble polysorbate; a compound selected from the group consisting of sorbitol and mannitol; polyvinylpyrrolidone (PVP); and water as a liquid carrier, wherein said dantrolene sodium and water are present together as a colloidal dispersion of dantrolene sodium particles in the water, wherein the dantrolene sodium particles are less than about 2 microns in average diameter, and wherein the formulation is safe for intravenous administration.
11. The method of claim 1 , wherein the compound is mannitol and the formulation comprises no more than 30 milligrams of mannitol per milligram of dantrolene.
12. The method of claim 1 , wherein the administering step further comprises administering a quantity of 3-150 milliliters of the formulation to the mammal.
13. The method of claim 12 , wherein the quantity is 10 milliliters or less.
14. The method of claim 13 , wherein the quantity is 5 milliliters or less.
15. The method of claim 1 , wherein the administering step further comprises administering a dose of 250-300 mg dantrolene sodium to the mammal.
16. The method of claim 12 , wherein the administering step further comprises administering a dose of 250-300 mg dantrolene sodium to the mammal.
17. The method of claim 1 , further comprising a step of: preparing the safe for injection, liquid formulation of dantrolene sodium by combining a dry formulation comprising: dantrolene sodium consisting essentially of dantrolene sodium particles less than about 2 microns in average diameter; a water-soluble polysorbate; and a compound selected from the group consisting of sorbitol and mannitol, said dry formulation being reconstitutable by water to provide a colloidal dispersion of dantrolene sodium particles less than about 2 microns in average diameter in the water that is safe for intravenous administration, with water to form a liquid formulation that is a colloidal dispersion of dantrolene sodium particles less than about 2 microns in average diameter in the water that is safe for intravenous administration, and in which the dantrolene sodium is present at a concentration in the range of 3.33 mg/ml to 166.67 mg/ml, and whereupon said combining, the liquid formulation is ready for injection.
18. The method of claim 17 , wherein said combining comprises mechanical agitation.
19. The method of claim 18 , wherein said combining is performed in one minute or less.
20. The method of claim 17 , wherein the dry formulation consists essentially of: dantrolene sodium consisting essentially of dantrolene sodium particles less than about 2 microns in average diameter; a water-soluble polysorbate; and a compound selected from the group consisting of sorbitol and mannitol.
21. The method of claim 1 , wherein the non-normothermic state is malignant hyperthermia.