2.5.1 Angiotensin-converting enzyme inhibitors
|enalapril maleate |
- tablets 2mg (named patient), 12.5mg, 25mg, 50mg; solution 5mg/ml (imported via IDIS)
Test dose (with patient supine;monitor blood pressure for 1-2 hours)
Maintenance dose (start low and titrate up as necessary)
- Birth-1 month, 10-50 microgram/kg as a single dose.
- 1 month-18 years, 100 microgram/kg (max. 6.25mg) as a single dose.
- Birth-1 month, 10-50microgram/kg three times a day. Max. 2mg/kg/day.
- 1 month-1 year, 100microgram-300microgram/kg three times a day. Max. 4mg/kg/day.
- 1-12 years, 100microgram-300microgram/kg three times a day. Max. 6mg/kg/day or 75mg daily.
- 12-18 years, 12.5-50mg two to three times a day.
- enalapril maleate tablets 2.5mg, 5mg, 10mg, 20mg
- 1 month-12 years, initially 100micrograms/kg once daily, monitor blood pressure carefully for 1-2 hours, increased as necessary up to max. 1mg/kg daily in 1-2 divided doses.
- 12-18 years, initially 2.5mg once daily, monitor blood pressure carefully for 1-2 hours, usual maintenance dose 10-20mg daily in 1-2 divided doses. Max. 40mg daily.
- Tablets can be halved and will disperse in water.
- For heart failure the dose of the ACE inhibitor should be titrated to a ‘target’ dose (or to the maximum tolerated dose if lower). See BNF.
- ACE inhibitors should be considered first–line antihypertensives in children with diabetes.
- Urea and electrolytes and renal function should be checked before and within 1 week of commencing therapy and monitored during treatment.
- Other ACE inhibitors such as lisinopril may be prescribed on an individual basis, especially in older children.