Anti-hypertensive drugs in children and adolescents

Table 3 Other commonly used “off-label” antihypertensive drugs¹

Drug class	Drug	Starting dose	Max dose	Frequency
Angiotensin converting enzyme inhibitor	Captopril	0.3-0.5 mg/kg per dose	6 mg/kg up to 450 mg/d	Two to three times daily
Beta blocker	Atenolol	0.5 mg/kg per day	2 mg/kg per day up to 100 mg	Once to twice daily
	Propranolol	1 mg/kg per day	16 mg/kg per day up to 640 mg	Two to four times daily
Calcium channel blocker	Extended release nifedipine	0.25 mg/kg per day	3 mg/kg per day up 120 mg/kg per day	Once to twice daily
Diuretic	Furosemide	0.5 mg/kg per dose	6 mg/kg per dose	Twice to three times daily
	Hydrochlorothiazide	0.5-1 mg/kg	3 mg/kg up to 50 mg	Daily

¹These drugs have not been well studied in pediatric clinical trials and dosing/safety/efficacy are largely extrapolated from trials in adults.