2.6.2 Calcium channel blockers
| First Choice: |
|---|
| nifedipine |
| or | amlodipine |
Dose
- nifedipine m/r tablets 10mg, 20mg, 30mg, 40mg, 60mg; capsules m/r 10mg, 20mg, 30mg, 60mg; liquid 20mg/mL (1mg per 0.05mL drop) named patient
(a) Hypertension
- 1 month-12 years, 200-300microgram/kg three times a day.
- 12-18 years, 5-20mg three times a day. Maximum dose 3mg/kg/day or 100mg/day. Dose frequency depends on preparation used; modified-release tablets may be crushed and administered immediately but this may alter the release properties.
(b) Hypertensive crisis
- All ages, 250-500microgram/kg as a single dose.
- amlodipine tablets 5mg, 10mg; suspension extemporaneously prepared. (Note: tablets may be dispersed in water)
- 1 month-12 years initially 100-200micrograms/kg once daily. Max. 10mg daily.
- 12-18 years initially 5mg once daily, increased according to response. Max. 10mg daily.
Prescribing Notes
- The smallest dose increment for nifedipine named patient liquid is 1mg.
- The brand of different calcium–channel blockers should be specified since different formulations may have different clinical effects. The most cost–effective brand should be prescribed.
- Short–acting formulations of nifedipine capsules have been associated with large variations in blood pressure and reflex tachycardia; they are no longer recommended for hypertension.
- Amlodipine should be used for maintenance treatment of hypertension in children who are unable to swallow solid dose forms.