Minoxidil

Generic name
Minoxidil
Brand name
ATC Code
C02DC01
Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

There is no information about the pharmacokinetic parameters for minoxidil in children.

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

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Hypertension
  • Oral
    • 1 year up to 12 years
      • Initial dose: 0.1 - 0.2 mg/kg/day in 1 - 3 doses. Max: 5 mg/day.
      • Maintenance dose: Gradually increase every 3 days if necessary to a maximum of 50 mg/day in 1 - 3 doses. Max: 50 mg/day.

      • Reduce minoxidil very gradually over at least 12 weeks. Be aware of the possibility of hypertensive encephalopathy as a result of rebound hypertension

    • 12 years up to 18 years
      • Initial dose: 5 mg/day in 1 - 3 doses.
      • Maintenance dose: Gradually increase every 3 days if necessary to a maximum of 100 mg/day in 1 - 3 doses. Max: 100 mg/day.

      • Reduce minoxidil very gradually over at least 12 weeks. Be aware of the possibility of hypertensive encephalopathy as a result of rebound hypertension

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.

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

Hypertrichosis, tachycardia, salt and water retention, exudative pericarditis.

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

Prescription only after consulting a paediatric nephrologist and/or paediatric cardiologist.
Adjusting the medication should preferably be done in a clinical setting.
Before the treatment is started it is recommended to reduce the antihypertensive therapy to a regimen consisting of a diuretic and a β blocker. The initial dose should be reduced if other inhibitors of the sympathetic nervous system are being used. If the desired reduction of the diastolic blood pressure is more than 30 mmHg, fluctuations can be reduced to a minimum by using multiple doses a day. For changes of the dosage an interval of at least three days should be observed. Where faster decreases in blood pressure is desired, under continuous blood pressure control the dose can be increased every 6 hours. In patients with severe renal insufficiency who undergo chronic dialysis a lower dosage may have been indicated.
If the therapy is discontinued after a successful course, the dosage should be reduced very gradually. Minoxidil should be replaced by another anti-hypertensive to appropriately cope with an increase in blood pressure.

Extra caution is recommended in children with a severe renal function disorder. Carefully check children for symptoms of cardiac failure or pericardial or pleural effusion, also check the renal function, urine production and the bodyweight.
 

Interactions

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

ARTERIOLAR SMOOTH MUSCLE, AGENTS ACTING ON

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Hydrazinophthalazine derivatives
C02DB01
Nitroferricyanide derivatives
C02DD01

References

  1. UpToDate, Inc., Pediatric Drug Information, 2011, http://www.uptodate.com/contents/minoxidil-systemic-drug-information?source=search_result&search=minoxidil&selectedTitle=1%7E34#F8774966
  2. Halling SE, et al, Minoxidil therapy in children and young adult patients with renal disease and refractory hypertension: value when multidrug regimens have failed to achieve blood pressure control, J Hum Hypertens, 2010, Aug;24(8):, 552-4
  3. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents, The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents, Pediatrics., 2004, Aug;114(2 Suppl 4th Report), 555-76.
  4. Fivush B, et al, Acute hypertensive crises in children: emergencies and urgencies, Curr Opin Pediatr., 1997, Jun;9(3), 233-6
  5. Strife CF, et al, Minoxidil for control of acute blood pressure elevation in chronically hypertensive children, Pediatrics, 1986, Nov;78(5), 861-5
  6. Makker SP, et al, Rebound hypertension following minoxidil withdrawal., J Pediatr, 1980, Apr;96(4):, 762-6
  7. Sinaiko AR, et al, Clinical response of hypertensive children to long-term minoxidil therapy, J Cardiovasc Pharmacol, 1980, 2 Suppl 2, S181-8

Changes

Therapeutic Drug Monitoring


Overdose