Table 8:
Pharmacological agents used in management of pediatric HTN
| Drug type | Drug | Starting dose | Maximum dose | Interval |
|---|---|---|---|---|
|
Angiotensin-converting enzyme inhibitors Common drug class side effects: cough, headache, dizziness, asthenia44 |
Benazepril45 | 0.2 mg/kg, up to 10 mg | 0.6 mg/kg, up to 40 mg | Daily |
| Captopril45 | 0.3-0.5 mg/kg | 6 mg/kg | Twice to three times daily | |
| Enalapril42 | 0.08 mg/kg/day | 0.6 mg/kg/day, up to 40 mg/day | Daily | |
| Fosinopril45 | 0.1-0.6 mg/kg | 40 mg | Daily | |
| Lisinopril45 | 0.08-0.6 mg/kg | 0.6 mg/kg, up to 40 mg | Daily | |
| Ramipril45 | 2.5 mg/m2 BSA | 6 mg/m2 BSA up to 10 mg | Daily | |
| Quinapril42 | 5-10 mg | 80 mg | Daily | |
|
Angiotensin receptor blockers Common drug class side effects: headache, dizziness44 |
Candesartan42 | 1-6 years: 0.2 mg/kg/day 6-17 years: <50 kg: 4-8 mg, >50 kg: 8-16 mg | 1-6 years: 0.4 mg/kg/day 6-17 years: 32 mg | Daily |
| Irbesartan45 | 75-150 mg | 300 mg | Daily | |
| Losartan45 | 0.7 mg/kg, up to 50 mg | 1.4 mg/kg, up to 100 mg | Daily | |
| Olmesartan42 | 20-35 kg: 10 mg, >35 kg: 20 mg | 20-35 kg: 20 mg, >35 kg: 40 mg | Daily | |
| Valsartan42 | <6 years: 5-10 mg/d, 6-17 years: 1.3 mg/kg/day, up to 40 mg | <6 years: 80 mg, 6-17 years: 2.7 mg/kg/day, up to 160 mg | Daily | |
|
Thiazide diuretics Common drug class side effects: hypokalemia, dizziness44 |
Chlorthalidone45 | 0.3 mg/kg | 2 mg/kg, up to 50 mg | Daily |
| Hydrochlorothiazide45 | 0.5-1 mg/kg | 3 mg/kg/day | Daily | |
|
Calcium channel blockers Common drug class side effects: peripheral edema, flushing, dizziness44 |
Amlodipine45 | 0.06-0.3 mg/kg | 5-10 mg | |
| Felodipine45 | 2.5 mg | 10 mg | Daily | |
| Nifedipine44 | 0.35-0.5 mg/kg | 3 mg/kg, up to 120 mg | Daily to twice daily | |
|
β-blockers Common drug class side effects: fatigue, diminished exercise ability, weight gain, worsening insulin sensitivity, onset of diabetes46 |
Labetalol45 | 2-3 mg/kg/day | 10-12 mg/kg/day, up to 1,200 mg/day | Twice daily |
| Atenolol45 | 1-3 mg/kg/day | 10-12 mg/kg/day, up to 1,200 mg/day | Twice daily | |
| Metoprolol45 | 0.5-1 mg/kg/day | 2 mg/kg/day | Daily to twice daily | |
| Carvedilol46 | 0.1 mg/kg per dose, up to 6.25 mg | 0.5 mg/kg per dose, up to 25 mg | Twice daily | |
|
α-blockers Common drug class side effects: postural hypotension with short-acting prazosin46 |
Prazosin45 | 0.05-0.1 mg/kg/day | 0.5 mg/kg/day | Three times daily |
| Doxazosin45 | 1 mg | 4 mg | Daily |
HTN: Hypertension, BSA: Body surface area, BP: Blood pressure