Class | Drug | Route | Dose range | Interval | Comments |
ACE inhibitors | Captopril | Oral | <3 months – 0.01 to 0.5 mg/kg/dose Maximum 2 mg/kg/day | 3 to 4 times per day |
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>3 months – 0.15 to 0.3 mg/kg/dose Maximum 6 mg/kg/day | |||||
Enalapril | Oral | 0.08 to 0.6 mg/kg/day | 1 or 2 times per day | ||
Lisinopril | Oral | 0.07 to 0.6 mg/kg/day | 1 time per day | ||
Alpha and beta antagonists | Labetalol | Oral | 0.5 to 1 mg/kg/dose Maximum 10 mg/kg/day | 2 or 3 times per day | Acute decompensated heart failure, bronchopulmonary dysplasia-relative contraindications |
IV bolus | 0.2 to 1 mg/kg/dose | Administer every 4 to 6 hours | |||
IV infusion | 0.25 to 3 mg/kg/hour | Continuous infusion | |||
Carvedilol | Oral | 0.1 mg/kg/dose up to 0.5 mg/kg/dose | 2 times per day | May be useful in chronic heart failure | |
Beta antagonists | Esmolol | IV infusion | 100 to 500 mcg/kg/minute | Continuous infusion | Very short-acting; constant infusion necessary May be useful for management of acute hypertension after repair of aortic coarctation |
Propranolol | Oral | 0.5 to 1 mg/kg/dose Maximum 8 to 10 mg/kg/day | 3 to 4 times per day | Monitor heart rate; avoid in bronchopulmonary dysplasia | |
Calcium channel blockers | Amlodipine | Oral | 0.05 to 0.3 mg/kg/dose Maximum 0.6 mg/kg/day | 1 time per day | May cause mild reflex tachycardia Some infants may benefit by dividing dose twice per day Full effect of dose adjustment may require 1 week or more |
Isradipine | Oral | 0.05 to 0.15 mg/kg/dose Maximum 0.8 mg/kg/day | 4 times per day | May cause mild reflex tachycardia | |
Nicardipine | IV infusion | 0.5 to 4 mcg/kg/minute | Continuous infusion | ||
Central alpha agonist | Clonidine | Oral | 5 to 10 mcg/kg/day Maximum 25 mcg/kg/day | Divided 2 to 4 times per day | May cause mild sedation |
Diuretics | Chlorothiazide | Oral | 5 to 15 mg/kg/dose | 2 times per day | Monitor electrolytes |
Hydrochlorothiazide | Oral | 1 to 3 mg/kg/day | 1 time per day, or as 2 divided doses per day | ||
Spironolactone | Oral | 0.5 to 1.5 mg/kg/dose | 2 times per day | ||
Vasodilators | Hydralazine | Oral | 0.25 to 1 mg/kg/dose Maximum 7.5 mg/kg/day | 3 to 4 times per day | Tachycardia and fluid retention are common side effects |
IV bolus | 0.15 to 0.6 mg/kg/dose | Q 4 hours | |||
Minoxidil | Oral | 0.1 to 0.2 mg/kg/dose | 2 to 3 times per day | Tachycardia and fluid retention common side effects; prolonged use causes hypertrichosis; pericardial effusion may occur | |
Nitroprusside | IV infusion | 0.5 to 10 mcg/kg/minute | Continuous infusion | Thiocyanate toxicity can occur with prolonged (>72 hour) use or in renal failure |
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