Oral ACE Inhibitors for Hypertension in Children

For neonates: Initial dose 0.01–0.05 mg/kg once a day to a maximum of 0.5 mg/kg 4 times a day

For younger children: Initial dose 0.2–0.5 mg/kg 2 to 4 times a day, or for older children 6.25–12.5 mg 2 to 4 times a day (maximum daily dose 6 mg/kg)

For adolescents: 12.5–25 mg 2 to 4 times a day (maximum daily dose 150 mg)

Common adverse effects: Cough, headache, dizziness

Severe adverse effects: Fetal toxicity, hyperkalemia, acute kidney injury, angioedema

Contraindications include pregnancy and history of angioedema.

Dosage adjustments are needed for children who have renal dysfunction.

For infants and children: Initial dose 0.08 mg/kg once a day (maximum daily dose 0.6 mg/kg or 5 mg)

For adolescents: Initial dose 2.5–5 mg once a day (maximum daily dose 40 mg)

For children < 6 years of age: Limited data

For children ≥ 6 years of age: Initial dose 0.07 mg/kg once a day with a maximum initial daily dose of 5 mg (titrated to a maximum daily dose of 40 mg once a day)