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2009 UpToDate

Antihypertensive drugs for outpatient management of


hypertension in children 1 to 17 years old (continued)

Class

Drug

Doxazosin

Dose*
Initial: 1
mg/d
Maximum:
4 mg/d

Alpha 1antagonist

Prazosin

Initial:
0.05-0.1
mg/kg per
d
Maximum:
0.5 mg/kg
per d

Terazosin

Initial: 1
mg/d
Maximum:
20 mg/d
Initial:
0.75
mg/kg per
d

Hydralazine

Maximum:
7.5 mg/kg
per d up
to 200
mg/d

Dosing
interval

Comments

once
daily

three
times
daily

May cause
hypotension
and syncope,
especially after
first dose.

once
daily

four
times
daily

1. Tachycardia
and fluid
retention are
common side
effects.
2. Hydralazine

mg/d

can cause a
lupus-like
syndrome in
slow
acetylators.

Children
<12
years:
Initial: 0.2
mg/kg per
d

Vasodilator

Maximum:
50 mg/d
Minoxidil
Children
12
years:
Initial: 5
mg/d

one to
three
times
daily

3. Prolonged
use of minoxidil
can cause
hypertrichosis.
4. Minoxidil is
usually
reserved for
patients with
hypertension
resistant to
multiple drugs.

Maximum:
100 mg/d

d: day.
* The maximum recommended adult dose should not be exceeded in
routine clinical practice.
Comments apply to all members of each drug class except where
otherwise stated.
Includes drugs with prior pediatric experience or recently completed
clinical trials.
Data from: National High Blood Pressure Education Program Working
Group on High Blood Pressure in Children and Adolescents. The
fourth report on the diagnosis, evaluation, and treatment of high
blood pressure in children and adolescents. Pediatrics 2004; 114 (2
Suppl 4th Report):555.

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