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 human at risk of developing a non-normothermic state, comprising intravenously administering to said human a formulation comprising: a salt of dantrolene; a polyvinylpyrrolidone; and water; wherein the formulation includes up to 500 mg of dantrolene in a volume of less than or equal to about 150 mL and wherein the concentration of dantrolene is 30-80 mg/mL; wherein the formulation is in the form of a stable colloidal suspension, and wherein the particles of the colloidal suspension are less than about 2 microns in average diameter.
2. The method of claim 1 , wherein the salt of dantrolene is a sodium, potassium, ammonium, calcium, or magnesium salt.
3. The method of claim 1 , wherein the salt of dantrolene is a sodium salt.
4. The method of claim 1 , wherein the volume is less than or equal to about 100 mL.
5. The method of claim 1 , wherein the volume is less than or equal to about 30 mL.
6. The method of claim 1 , wherein the volume is less than or equal to about 5 mL.
7. The method of claim 1 , wherein the particles are less than 0.8 microns in average diameter.
8. The method of claim 1 , wherein the particles are less than 0.45 microns in average diameter.
9. The method of claim 1 , wherein said formulation further comprises lactose, trehalose, sorbitol, sucrose, dextrose, or mannitol.
10. The method of claim 1 , wherein the non-normothermic state is malignant hyperthermia.
11. The method of claim 1 , wherein the non-normothermic state is heat stroke.
12. The method of claim 1 , wherein the method prevents the human from developing the non-normothermic state.
13. The method of claim 12 , wherein the non-normothermic state is malignant hyperthermia.
14. The method of claim 12 , wherein the non-normothermic state is heat stroke.
15. A method of treating a human at risk of developing a non-normothermic state, wherein said method comprises reconstituting a lyophilized formulation comprising up to 500 mg of dantrolene or a salt of dantrolene, polyvinylpyrrolidone, and optionally, lactose, trehalose, sorbitol, sucrose, dextrose, or mannitol to provide an injectable, colloidal suspension wherein the concentration of dantrolene is 30-80 mg/mL, and the particles of the colloidal suspension are less than about 2 microns in average diameter;
and intravenously administering to said human the colloidal suspension.
16. The method of claim 15 , wherein said lyophilized formulation comprises up to 500 mg of dantrolene.
17. The method of claim 15 , wherein said lyophilized formulation comprises up to 300 mg of dantrolene.
18. The method of claim 15 , wherein said lyophilized formulation comprises mannitol.
19. The method of claim 15 , wherein the particles are less than 0.8 microns in average diameter.
20. The method of claim 15 , wherein the particles are less than 0.45 microns in average diameter.
21. The method of claim 15 , wherein the non-normothermic state is malignant hyperthermia.
22. The method of claim 15 , wherein the non-normothermic state is heat stroke.
23. The method of claim 15 , wherein the method prevents the human from developing the non-normothermic state.
24. The method of claim 23 , wherein the non-normothermic state is malignant hyperthermia.
25. The method of claim 23 , wherein the non-normothermic state is heat stroke.