Dose of nifidipine in pediatric
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I have the full table data. Here is the complete, authoritative answer:
Nifedipine Dosing in Pediatrics
Source: The Harriet Lane Handbook, 23rd edition (Johns Hopkins Hospital)
Hypertensive Urgency / Emergency (Enteral Therapy)
| Parameter | Details |
|---|---|
| Route | PO or SL (sublingual) |
| Dose | 0.1-0.25 mg/kg/dose Q4-6 hr |
| Max per dose | 10 mg/dose |
| Max daily dose | 1-2 mg/kg/24 hr |
| Mechanism | Calcium channel blocker (dihydropyridine) |
| Side effects | Reflex tachycardia |
Additional Context from Tintinalli's Emergency Medicine
For congestive heart failure in congenital heart disease, nifedipine is cited at 0.25-1.0 mg/kg PO, but is contraindicated in infants <1 year of age.
Key Clinical Points
- Indication: Hypertensive urgency (non-emergency) in children; also used in pulmonary hypertension and some cardiac conditions.
- Formulation note: Immediate-release nifedipine capsules are used for acute dosing; the liquid contents can be swallowed or given sublingually.
- Age restriction: Avoid in infants under 1 year due to unpredictable absorption and risk of precipitous hypotension.
- Caution: Sublingual route causes rapid, sometimes uncontrolled BP drops - many centers now prefer oral administration for more predictable pharmacokinetics.
- For true hypertensive emergencies (with end-organ damage), IV agents (nicardipine, labetalol, nitroprusside) are preferred over oral nifedipine.
- The Harriet Lane Handbook, 23rd ed., Table 1.8 (Hypertensive Emergency/Urgency Medications)
- Tintinalli's Emergency Medicine, Treatment of CHF in Congenital Heart Disease
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