Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Amlodipine

Generic name
Amlodipine
Brand name
ATC Code
C08CA01

Pharmacokinetics in children

The study by Flynn (2006) shows that the weight-corrected clearance is higher in young children (ages < 6 years). Young children need higher doses than older children:
Cl (oral) 1-5 yrs: 1.0±0.33 l/kg/hour
Cl (oral) 6-12 yrs: 0.63±0.36 l/kg/hour
Cl (oral) 13-17 yrs: 0.40±0.16 l/kg/hour
Vd 1-5 yrs: 44.5±12.5 l/kg
Vd 6-12 yrs: 27±8.8 l/kg
Vd 12-17 yrs: 21.6±6.4 l/kg
High interindividual variability in exposure has been observed.



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dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

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Available formulations

No information is present at this moment.

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Dosages

Hypertension
  • Oral
    • 1 month up to 18 years
      • 0.1 - 0.3 mg/kg/day in 1 - 2 doses. Max: 0.6mg/kg/day, but not exceeding 20 mg/day.
      • Young children (< 6 years) should be dosed twice daily.
        Dose adjustments should not be more often than once every 5 to 7 days.

    • < 1 month
      • No studies have been carried out in this age category

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Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Oedema, fatigue, dizziness, headaches, flushing, nausea, abdominal pain and gingival recession. In peritoneal dialysis, leukocytosis can occur in the effluent.

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Caution is needed in hepatic insufficiency as t½ may then be lengthened. Dose adjustments should not be more often than once every 5 to 7 days.

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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Dihydropyridine derivatives
C08CA04
C08CA05

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References

  1. Tallian KB, et al., Efficacy of amlodipine in pediatric patients with hypertension, Pediatr Nephrol, 1999, 13, 304-10
  2. Flynn JT., Efficacy and safety of prolonged amlodipine treatment in hypertensive children, Pediatr Nephrol, 2005, 20, 631-5
  3. Flynn JT, et al, Population pharmacokinetics of amlodipine in hypertensive children and adolescents., J Clin Pharmacol, 2006, 46, 905-16
  4. Andersen J, et al,, Preliminary experience with amlodipine in the pediatric population, Am J Ther, 2006, 13, 198-204
  5. Von Vigier RO, et al, Antihypertensive efficacy of amlodipine in children with chronic kidney diseases., J Hum Hypertens, 2001, 15, 387-91
  6. Lee F et al. , Association between peritoneal dialysate effluent leukocytosis and amlodipine besylate. , Am J Kidney Dis, 2009, Mar;53(3):, e1-3.
  7. Pfizer BV, SPC Norvasc 5, 10 mg tablet (RVG 13348) 08-02-13, www.cbg-meb.nl
  8. Lee F et al., Association between peritoneal dialysate effluent leukocytosis and amlodipine besylate., Am J Kidney Dis, 2009, Mar;53(3):, e1-3.

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Changes

Changes