TABLE 17

Dosing Recommendations for the Initial Prescription of Antihypertensive Drugs for Outpatient Management of Chronic HTN

DrugAgeInitial DoseMaximal DoseDosing IntervalFormulations
ACE inhibitors
 Contraindications: pregnancy, angioedema
 Common adverse effects: cough, headache, dizziness, asthenia
 Severe adverse effects: hyperkalemia, acute kidney injury, angioedema, fetal toxicity
Benazepril≥6 ya0.2 mg/kg per d (up to 10 mg per d)0.6 mg/kg per d (up to 40 mg per d)DailyTablet: 5, 10, 20, 40 mg (generic)
Extemporaneous liquid: 2 mg/mL
CaptoprilInfants0.05 mg/kg per dose6 mg/kg per dDaily to 4 times a dayTablet: 12.5, 25, 50, 100 mg (generic)
Children0.5 mg/kg per dose6 mg/kg per dThree times a dayExtemporaneous liquid: 1 mg/mL
Enalapril≥1 moa0.08 mg/kg per d (up to 5 mg per d)0.6 mg/kg per d (up to 40 mg per d)Daily to twice a dayTablet: 2.5, 5, 10, 20 mg (generic)
Solution: 1 mg/mL
Fosinopril≥6 y0.1 mg/kg per d (up to 5 mg per d)40 mg per dDailyTablet: 10, 20, 40 mg (generic)
<50 kg
≥50 kga5 mg per d40 mg per d
Lisinopril≥6 ya0.07 mg/kg per d (up to 5 mg per d)0.6 mg/kg per d (up to 40 mg per d)DailyTablet: 2.5, 5, 10, 20, 30, 40 mg (generic)
Solution: 1 mg/mL
Ramipril1.6 mg/m2 per d6 mg/m2 per dDailyCapsule: 1.25, 2.5, 5 10 mg (generic)
Quinapril5 mg per d80 mg per dDailyTablet: 5, 10, 20, 40 mg (generic)
ARBs
 Contraindications: pregnancy
 Common adverse effects: headache, dizziness
 Severe adverse effects: hyperkalemia, acute kidney injury, fetal toxicity
Candesartan1–5 ya0.02 mg/kg per d (up to 4 mg per d)0.4 mg/kg per d (up to 16 mg per d)Daily to twice a dayTablet: 4, 8, 16, 32 mg
≥6 yaExtemporaneous liquid: 1 mg/mL
<50 kg4 mg per d16 mg per d
≥50 kg8 mg per d32 mg per d
Irbesartan6–12 y75 mg per d150 mg per dDailyTablet: 75, 150, 300 mg (generic)
≥13150 mg per d300 mg per d
Losartan≥6 ya0.7 mg/kg (up to 50 mg)1.4 mg/kg (up to 100 mg)DailyTablet: 25, 50 100 (generic)
Extemporaneous liquid: 2.5 mg/mL
Olmesartan≥6 yaDailyTablet: 5, 20, 40 mg
<35 kg10 mg20 mgExtemporaneous liquid: 2 mg/mL
≥35 kg20 mg40 mg
Valsartan≥6 ya1.3 mg/kg (up to 40 mg)2.7 mg/kg (up to 160 mg)DailyTablet: 40, 80, 160, 320 mg (generic)
Extemporaneous liquid: 4 mg/mL
Thiazide diuretics
 Contraindications: anuria
 Common adverse effects: dizziness, hypokalemia
 Severe adverse effects: cardiac dysrhythmias, cholestatic jaundice, new onset diabetes mellitus, pancreatitis
ChlorthalidoneChild0.3 mg/kg2 mg/k per d (50 mg)DailyTablet: 25, 50, 100 mg (generic)
ChlorothiazideChilda10 mg/kg per d20 mg/kg per d (up to 375 mg per d)Daily to twice a dayTablet: 250, 500 mg (generic)
Suspension: 250/5 mL
Extemporaneous liquid: 1 mg/mL
HydrochlorothiazideChilda1 mg/kg per d2 mg/kg per d (up to 37.5 mg per d)Daily to twice a dayTablet: 12.5, 25, 50 mg
Calcium channel blockers
 Contraindications: hypersensitivity to CCBs
 Common adverse effects: flushing, peripheral edema, dizziness
 Severe adverse effects: angioedema
Amlodipine1–5 y0.1 mg/kg0.6 mg/kg (up to 5 mg per d)DailyTablet: 2.5, 5,10 mg
≥6 ya2.5 mg10 mgExtemporaneous liquid: 1 mg/mL
Felodipine≥6 y2.5 mg10 mgDailyTablet (extended release): 2.5,5,10 mg (generic)
IsradipineChild0.05–0.1 mg/kg0.6 mg/kg (up to 10 mg per d)Capsule: twice daily to 3 times a day; extended-release tablet: dailyCapsule: 2.5, 5 mg
Extended-release tablet: 5, 10 mg
Nifedipine extended releaseChild0.2–0.5 mg/kg per d3 mg/kg/d (up to 120 mg per d)Daily to twice a dayTablet (extended-release): 30, 60, 90 mg (generic)
  • —, not applicable.

  • a FDA pediatric labeling.