Medicamentos para hipertensión intracraneal
Estos son los medicamentos que KitCal reúne para hipertensión intracraneal. La elección depende de la edad, la gravedad, el germen o la causa, y de las guías locales.
Dosis de cada medicamento
Dosis por kilo de peso tal como figuran en KitCal. En la app se ingresa el peso y se obtiene la dosis en mg y el volumen a administrar.
Dexametasona
| Presentación | Dosis | Frecuencia | Dosis máxima |
|---|---|---|---|
| Jarabe Oral 0.5mg/5cc · 2mg/5cc | Asma0.3mg/kg x dosis | cada 24 horas | 8mg |
| Crup Leve0.15mg/kg x dosis | — | 8mg | |
| Tableta Oral 0.5mg · 1mg · 4mg | Asma0.3mg/kg x dosis | cada 24 horas | 8mg |
| Crup Leve0.15mg/kg x dosis | — | 8mg | |
| Ampolla Endovenosa; Intramuscular 4mg/2ml · 8mg/2ml | Asma0.3mg/kg x dosis | cada 24 horas | 8mg |
| Crup Mod. a Sev0.6mg/kg x dosis | — | 8mg | |
| Hipert. Intracraneal D.I.0.5mg/kg x dosis | Dosis Inicial | 8mg | |
| Hipert. Intracraneal D.M.0.25mg/kg x dosis | cada 6-8 horas | 8mg |
Si se usa más de 7 días; suspender gradualmente. Dosis Máxima: 8mg/kg/dosis
No usar más de 7 días; suspender gradualmente. Dosis Máxima: 8mg/kg/dosis
Dosis Meningitis Bacteriana: 0.6 - 0.8 mg/kg por dosis cada 6 - 12 horas
Fenobarbital
| Presentación | Dosis | Frecuencia | Dosis máxima |
|---|---|---|---|
| Ampolla Endovenosa 200mg/2cc | D.I. Anticonvulsivante10-20mg/kg x dosis | — | 200mg |
| D.M. Anticonvulsivante4-6mg/kg x día | cada 8-12 horas | 200mg | |
| Estatus epiléptico10mg/kg x día | cada 20-30 horas | 200mg | |
| D.U. Ictericia neonatal4-6mg/kg x dosis | Dosis única | 200mg | |
| Tableta Oral 100mg | D.M. anticonvulsivante4 - 6 mg/kg x día | cada 8 - 12 horas | 200mg |
Dosis máxima: 200 mg/dosis y/o 600mg/día
Sobredosis produce depresión respiratoria e hipotensión
D.I. Anticonvulsivante: EV lento (50 mg en 2 a 3 min)
D.U. Ictericia neonatal: Intramuscular (dosis)
Dosis máxima: 200 mg/dosis y/o 600mg/día
Sobredosis produce depresión respiratoria e hipotensión
Manitol
| Presentación | Dosis | Frecuencia | Dosis máxima |
|---|---|---|---|
| Ampolla Intravenosa 200mg/1cc | Edema Cerebral500-1500mg/kg x dosis | cada 4-6 horas durante 24h o menos (administrar en 20-30 min) | — |
| D.I. insuficiencia hepática500mg/kg x dosis | — | 6000g | |
| D.M. insuficiencia hepática250mg/kg x dosis | cada 6 horas | 6000g | |
| Prueba de Manitol250mg/kg x dosis | — | — |
Contraindicado en: Anuria; edema pulmonar; deshidratación y hemorragia intracraneana
D.M. insuficiencia hepática: durante 3 - 4 días
Prueba de manitol: 0.75g x S.C o 0.25g x kg; Prueba negativa -> diuresis menor de 12 ml/m2/h o 0.5 ml/kg/h
Solución Salina Hipertónica
| Presentación | Dosis | Frecuencia | Dosis máxima |
|---|---|---|---|
| Ampolla Endovenosa; Nebulización 3% | HTE en bolos2-5 ml/kg x dosis | cada 2-4-6-8 horas | — |
| HTE inf continua0.1-1 ml/kg x dosis | — | — | |
| Bronquiolitis 1ra fase4 ml. x dosis | Cada 20 min. 3 veces | — | |
| Bronquiolitis 2da fase4 ml. x dosis | Cada 30 min. 4 veces | — |
Solución 3% → Preparar mezclando 9 ml de NaCl al 0.9% y 1 ml de NaCl al 20%
Hipertensión endocraneana en bolos c/2-4-6-8 horas; suspender o disminuir si la osmolaridad sérica es mayor de 360 mOsm o Na sérico mayor a 170 mmol/L
Fuentes
Ver las 37 referencias de estos medicamentos
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- Li R, Wang Y, Zhang L, Chen H, Liu M. Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis. BMC Gastroenterol. 2025;25(1):577. DOI: 10.1186/s12876-025-04169-3.
- Makkar JK, Singh NP, Chawla JK, Sondekoppam RV, Singh PM. Efficacy of different routes of dexamethasone administration for preventing rebound pain following peripheral nerve blocks in adult surgical patients: a systematic review and network meta-analysis. Anaesthesia. 2025;80(6):704-712. DOI: 10.1111/anae.16566.
- Lee N, Han SM, Mukadi P, Edwards T, Maung HT, Smith C, et al. Corticosteroids for treatment of leptospirosis. Cochrane Database Syst Rev. 2026;(2):CD012345.
- Hay S, Ovelman C, Zupancic JAF, Doyle LW, Onland W, Konstantinidis M, et al. Systemic corticosteroids for the prevention of bronchopulmonary dysplasia, a network meta-analysis. Cochrane Database Syst Rev. 2025;(3):CD013730.
- Hematology Advisor. Dexamethasone Tablets: Drug information [Internet]. Cranbury: Hematology Advisor; 2023 [consultado 17 febrero 2026]. Disponible en: https://www.hematologyadvisor.com/drug/dexamethasone-tablets/
- Medcrine. Dexamethasone: Uses, Dosage, Mechanism of action and Side effects [Internet]. Medcrine; 2025 [consultado 17 febrero 2026]. Disponible en: https://medcrine.com/dexamethasone-uses-dosage-mechanism-of-action-and-side-effects
- Phenobarbital Sodium Injection: package insert / prescribing information [Internet]. Tampa (FL): Drugs.com; 2026 Ene 4 [actualizado 2026 Ene 4; citado 2026 Feb 12]. Disponible en: https://www.drugs.com/pro/phenobarbital-sodium-injection.html
- Phenobarbital Oral Solution: package insert / prescribing information [Internet]. Tampa (FL): RxDrugLabels.com (Ajenat Pharmaceuticals); 2025 Sep [citado 2026 Feb 12]. Disponible en: https://rxdruglabels.com/lib/rx/rx-meds/phenobarbital-oral-solution-1/page/3/
- Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate and Scopolamine Hydrobromide Tablets: package insert / prescribing information [Internet]. Tampa (FL): Drugs.com; 2026 Ene 12 [actualizado 2026 Ene 12; citado 2026 Feb 12]. Disponible en: https://www.drugs.com/pro/phenobarbital-hyoscyamine-sulfate-atropine-sulfate-and-scopolamine-hydrobromide-tablets.html
- Scherer A, Prunty J. Management of Antiseizure Medications in Pregnancy. US Pharm. 2025;50(9):HS-1-HS-7.
- Therapeutic Guidelines Ltd. What's New: Neurology [Internet]. Melbourne: Therapeutic Guidelines Australia; 2025 Dic [citado 2026 Feb 12]. Disponible en: https://www.tg.org.au/products/therapeutic-guidelines/updates eurology/
- Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology. 2018;91(2):74-81. doi: 10.1212/WNL.0000000000005755
- Ul Haq U, Ullah I, Farrukh MJ, et al. Phenobarbital versus valproate for generalized convulsive status epilepticus in adults: An updated systematic review and meta-analysis. Epilepsy Res. 2025;215:107571. doi: 10.1016/j.eplepsyres.2025.107571
- Gregorio GEV, Villanueva CA, Fojas MCJ. Efficacy, Effectiveness, and Safety of Phenobarbital in the Treatment of Cholestasis and as a Premedication to Improve Diagnostic Accuracy of Hepatobiliary Scintigraphy: A Systematic Review. Acta Med Philipp. 2025;59(10):95-109. doi: 10.47895/amp.vi0.10948
- Kaplan YC, Demir O. Use of Phenytoin, Phenobarbital Carbamazepine, Levetiracetam Lamotrigine and Valproate in Pregnancy and Breastfeeding: Risk of Major Malformations, Dose-dependency, Monotherapy vs Polytherapy, Pharmacokinetics and Clinical Implications. Curr Neuropharmacol. 2021;19(11):1805-1824. doi: 10.2174/1570159X19666210211150856
- Phenobarbital Sodium Injection [package insert]. 2026. (Contenido en referencia 1)
- Carney N, Totten AM, O'Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017
- Cook AM, Morgan Jones G, Hawryluk GWJ, Mailloux P, McLaughlin D, Papangelou A, et al. Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients. Neurocrit Care. 2020
- awryluk GWJ, Aguilera S, Buki A, Bulger E, Citerio G, Cooper DJ, et al. A management algorithm for patients with intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC). Intensive Care Med. 2019
- Kamel H, Navi BB, Nakagawa K, Hemphill JC 3rd, Ko NU. Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials. Crit Care Med. 2011
- Menegaz de Almeida A, Viana P, Marinheiro G, Hoffmann Relvas J, Lopes L, Lima Guilherme G, et al. Hypertonic Saline Solution Versus Mannitol for Brain Relaxation During Craniotomies: A Systematic Review and Updated Meta-Analysis. Neurosurgery. 2024
- Karamian A, Seifi A, Lucke-Wold B. Comparing the effects of mannitol and hypertonic saline in severe traumatic brain injury patients with elevated intracranial pressure: a systematic review and meta-analysis. Neurol Res. 2024
- Iqbal U, Kumar A, Arsal SA, Shafique MA, Bin Amin S, Raja A, et al. Efficacy of hypertonic saline and mannitol in patients with traumatic brain injury and cerebral edema: a systematic review and meta-analysis. Egypt J Neurosurg. 2023
- Mangat HS, Wu X, Gerber LM, Schwarz JT, Fakhar M, Murthy SB, et al. Hypertonic Saline is Superior to Mannitol for the Treatment of Intracranial Hypertension in Severe Traumatic Brain Injury. Neurocrit Care. 2020
- Miyoshi Y, Kondo Y, Suzuki H, Fukuda T, Yasuda H, Yokobori S, et al. Effects of hypertonic saline versus mannitol in patients with traumatic brain injury in prehospital, emergency department, and intensive care unit settings: A systematic review and meta-analysis. J Intensive Care. 2020
- Schwimmbeck F, Voellger B, Chappell D, Eberhart L. Hypertonic saline versus mannitol for brain relaxation in patients undergoing craniotomy: a systematic review and meta-analysis. J Neurosurg Anesthesiol. 2021
- Menegaz de Almeida A, Viana P, Marinheiro G, Hoffmann Relvas J, Lopes L, Lima Guilherme G, et al. Hypertonic saline solution versus mannitol for brain relaxation during craniotomies: a systematic review and updated meta-analysis. Neurosurgery. 2024;95(3):517-526. DOI: 10.1227 eu.0000000000002929.
- Cai L, He W. Effectiveness of hypertonic saline infusion in management of traumatic brain injury: an updated systematic review and meta-analysis of randomized controlled trials. Brain Inj. 2024;38(12):977-984. DOI: 10.1080/02699052.2024.2363340.
- Abdelmonem S, Elbahnasawy M, Aboelsuod M, Elshafie A, Abdelaziz M, Elgohary A, et al. Efficacy of hypertonic saline and mannitol in patients with traumatic brain injury and cerebral edema: a systematic review and meta-analysis. Egypt J Neurosurg. 2023;38:54. DOI: 10.1186/s41984-023-00233-w.
- Muscat N, Calleja E, Zammit C, Debono J, Cassar K, Spiteri N. The safety and efficacy of hypertonic saline in achieving primary fascial closure following damage control laparotomy: a systematic review and meta-analysis. Cureus. 2024;16(9):e70583. DOI: 10.7759/cureus.70583.
- Holden DN, Mucksavage JJ, Cokley JA, Gingras MA, Miano TA, Bose S, et al. Hypertonic saline use in neurocritical care for treating cerebral edema: a review of optimal formulation, dosing, safety, administration and storage. Am J Health Syst Pharm. 2023;80(6):331-342. DOI: 10.1093/ajhp/zxac368.
- Children's Hospital of Eastern Ontario (CHEO). Sodium chloride 3% (hypertonic): parenteral manual [Internet]. Ottawa: CHEO; revised 2024 Aug [cited 2026 Feb 16]. Available from: https://outreach.cheo.on.ca/manual/1707.
- University of Maryland School of Medicine. UMEM educational pearls: administration of 3% sodium chloride for acute or symptomatic hyponatremia [Internet]. Baltimore: UMSOM; 2024 Nov 6 [cited 2026 Feb 16]. Available from: https://em.umaryland.edu/educational_pearls/4548/.
Preguntas frecuentes
¿Qué medicamentos se usan para hipertensión intracraneal?
KitCal reúne 4 medicamentos para hipertensión intracraneal: Dexametasona, Fenobarbital, Manitol y Solución Salina Hipertónica. La elección depende de la edad, la gravedad y las guías locales.
¿Cuál es la dosis de dexametasona para hipertensión intracraneal?
Dexametasona (Jarabe): 0.3mg/kg x dosis, cada 24 horas. Dosis máxima: 8mg. Con el peso del paciente, KitCal calcula la dosis y el volumen exactos.
¿Cómo se calcula la dosis por peso?
Se multiplica la dosis por kilo por el peso del paciente y se divide según la frecuencia indicada, sin superar la dosis máxima. Después se convierte a volumen según la concentración de la presentación. La app de KitCal hace este cálculo automáticamente.
Otras patologías
Contenido referencial para profesionales de la salud. No reemplaza el juicio clínico ni la evaluación del paciente.