Oral Vasodilators for Hypertension in Children

In infants and children: Initial dose 0.375–0.5 mg/kg twice a day or 0.187–0.25 mg/kg 4 times a day up to maximum daily total dose in infants 5 mg/kg and in children maximum daily total dose 7.5 mg/kg (not to exceed 200 mg)

Headache, dizziness, and reflex tachycardia

Use with caution in severe renal and cardiac disease.

Dosage adjustments are needed for children who have renal dysfunction.

For children < 12 years of age: Initial dose 0.1–0.2 mg/kg (not to exceed 5 mg) once a day increased as needed up to 0.33 mg/kg 3 times a day, maximum daily total dose 50 mg

For children ≥ 12 years of age: Initial dose 5 mg once a day, increased as needed up to 20 mg twice a day (or 12.5 mg 3 times a day), effective range 10–40 mg/day

Common adverse effects: Dizziness, hypertrichosis, reflex tachycardia, fluid retention

Severe adverse effects: Heart failure, pulmonary edema, Stevens-Johnson syndrome

Contraindicated in acute myocardial infarction or pheochromocytoma.

This drug causes significant reflex tachycardia and fluid retention, so may need to be used with a beta-blocker and diuretic.

Dosage adjustments are needed for children who have renal dysfunction.