Spasticity
- PO (Adults): 25 mg once daily for 7 days, then 25 mg 2 times daily for 7 days, then 50 mg 3 times daily for 7 days, then 100 mg 3 times daily; may ↑ to 100 mg 4 times daily, if needed.
- PO (Children ≥5 yr): 0.5 mg/kg once daily for 7 days, then 0.5 mg/kg 3 times daily for 7 days, then 1 mg/kg 3 times daily for 7 days, then 2 mg/kg 3 times daily (not to exceed 400 mg/day).
Prevention of Malignant Hyperthermia
- PO (Adults and Children ≥5 yr): 4–8 mg/kg/day in 3–4 divided doses for 1–2 days before procedure, with last dose 3–4 hr preoperatively.
- IV (Adults and Children): 2.5 mg/kg given 75 min before surgery.
Treatment of Malignant Hyperthermia
- IV (Adults and Children): At least 1 mg/kg, continued until symptoms ↓ or a cumulative dose of 10 mg/kg has been given. If symptoms reappear, dose may be repeated.
Neuroleptic Malignant Syndrome (unlabeled)
- IV (Adults): 1–2.5 mg/kg initially; if rapid resolution of hyperthermia and rigidity is observed, may follow with 1 mg/kg every 6 hours (max dose = 10 mg/kg/day). After the patient is stabilized and symptoms have resolved, consider taper over days to weeks (do not abruptly discontinue).
