Table 5.
Main drug classes that can be used in children.
| Class | Drug | Initial dose | Dose per 24 h | No. doses/24 h | Undesirable effects, precautions |
|---|---|---|---|---|---|
| Calcium channel blockers | Amlodipine | 0.1–0.2 mg/kg Max 5 mg |
0.6 mg/kg/d Max 10 mg/d |
1 | Preparation of a 1 mg/mL suspension of amlodipine otherwise tablets of 2.5, 5 or 10 mg Tachycardia, flushing, headache, possible peripheral oedema, gingival hypertrophy |
| Nicardipine LP | 0.25–0.5 mg/kg/d | 1–3 mg/kg/d Max 120 mg/d |
2 | ||
| Felodipine | 5 mg | 10 mg | 1 | ||
| ACE inhibitors | Captopril | Liquid formulation: 5 mg/5 ml and 25 mg/5 ml Newborns: 0.01–0.03 mg/kg/dose Infants: 0.1 mg/kg/dose Older children: 0.3–0.5 mg/kg/dose |
6 mg/kg/d Max 150 mg |
1 to 3 | Monitoring of electrolytes after introduction or increase in dosage (hyperkalaemia, kidney failure) Cough and angioedema under ACE inhibitors Contraindicated during pregnancy (fetotoxicity) Treatment should be interrupted in case of gastroenteritis/dehydration |
| Enalapril | Newborns: 0.05 mg/kg/dose Infants: 0.05 mg/kg/dose Older children: 0.08 mg/kg/dose max 5 mg |
0.8 mg/kg/d Max 40 mg/d |
1 | ||
| Lisinopril | 0.08 mg/kg Max 5 mg/d |
0.6 mg/kg/d Max 40 mg/d |
1 | ||
| ARBs | Losartan* | 0.7 mg/kg/d Max 50 mg/d |
1.4 mg/kg/d Max 100 mg/d |
1 | |
| Irbesartan | 2 mg/kg/d | 6–12 years <35 kg: 75–150 mg/d ≥13 years >35 kg: 150–300 mg/d | 1 | ||
| Valsartan | 3 mg/ml drug with liquid formulation | – 1–6 years: 1 mg/kg/d and <4 mg/kg/d – 6–18 years: <35 kg: 20 mg/d and <40 mg/ d >35 kg: 40 mg/d and <80 mg/d |
|||
| Beta blockers | Acebutolol | 1.5–3 mg/kg/d | 5–15 mg/kg/d | 1 to 2 | Contraindications: AV block not cardioselective (Propranolol); contraindicated in case of asthma and heart failure Limit certain athletic performances |
| Acebutolol | 40 mg/ml in liquid formulation | 10–20 mg/kg/d | 1 to 2 | ||
| Propranolol | 1 mg/kg/d | 4 mg/kg/d Max 640 mg/d |
2 to 3 | ||
| Atenolol | 0.1–1 mg/kg/d | 2 mg/kg/d Max 100 mg/d |
1 to 2 | ||
| Alpha and beta blocker | Labetolol | 1–3 mg/kg/d | 10–15 mg/kg/d Max 1,200 mg/d |
2 | Contraindications: AV block, asthma, heart failure Limit certain athletic performances |
| Alpha blockers | Prazosin | 0.05–0.1 mg/kg/d Max 0.5 mg × 2 per d |
0.5 mg/kg/d Max 20 mg per d |
2 to 3 | Risk of orthostatic hypotension after the 1st dose Fatigue, concentration difficulties |
| Clonidine | 5 μg/kg/d | 30 μg/kg/d max 1.05 mg/d |
2 to 3 | ||
| Diuretics | Hydrochlorothiazide | 0.5–1 mg/kg/d | 3 mg/kg/d Max 50 mg/d |
1 | Monitoring of electrolytes Furosemide is useful for the complementary treatment of HTN in case of kidney failure |
| Furosemide | 0.5–2 mg/kg/dose | 6 mg/kg/d | 1 to 2 | ||
| Spironolactone* | 1 mg/kg/d | 3.3 mg/kg/d Max 100 mg/d |
1 to 2 |
*
Tablets can be crushed doses are given as examples, and the prescription of the drug should remain the physician's own responsibility.