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Antihypertensive efficacy of amlodipine in children with chronic kidney diseases

Abstract

In adults the calcium antagonist amlodipine given once a day has proved to be an attractive addition to the antihypertensive armamentarium. The present report describes our experience in 43 paediatric outpatients (26 boys and 17 girls, aged between 1.1 and 19, median 9.8 years) with chronic kidney diseases. The patients were given amlodipine for 16 weeks as part of their antihypertensive treatment. Before amlodipine arterial pressure was 150 (142–163)/90 (84–95) mm Hg (median and interquartile range). Six patients withdrew from amlodipine because of oedema, flushing or headache. In the remaining patients amlodipine 7.7 (6.9–9.4) mg/m2 body surface area once a day significantly decreased arterial pressure by 17 (13–22)/10 (7–13) mm Hg. The efficacy of amlodipine was more pronounced in girls than in boys. No changes in heart rate, body weight and circulating haemoglobin, sodium, potassium and creatinine were noted. In none of the patients circulating potassium, sodium or creatinine changed by more than 0.5 mmol/l, 5 mmol/l respectively 20%. In 11 patients concomitantly treated with cyclosporine the dosage and the trough-level of this agent were stable throughout the trial. In conclusion the present experience in paediatric outpatients with chronic kidney diseases supports the view that amlodipine is an effective and rather well tolerated antihypertensive drug when given once a day.

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References

  1. Tyler HM Amlodipine: an effective once-daily antihypertensive agent J Hum Hypertens 1991 5 (Suppl 1) 61–66

    Google Scholar 

  2. Kaplan NM Amlodipine in the treatment of hypertension Postgrad Med J 1991 67 (Suppl 5) S15–S19

    Google Scholar 

  3. Clavijo GA, de Clavijo IV, Weart CW Amlodipine: a new calcium antagonist Am J Hosp Pharm 1994 51 59–68

    CAS  Google Scholar 

  4. Staessen JA et alEfficacy of antihypertensive drugs given once a day: the calcium antagonists revisited J Hypertens Suppl 1994 12 S107–S115

    CAS  PubMed  Google Scholar 

  5. Reid JL, Meredith PA, Donnelly R, Elliott HL Pharmacokinetics of calcium antagonists J Cardiovasc Pharmacol 1988 12 (Suppl 7) S22–S26

    Article  Google Scholar 

  6. Abernethy DR The pharmacokinetic profile of amlodipine Am Heart J 1989 118 1100–1103

    Article  CAS  Google Scholar 

  7. Meredith PA, Elliott HL Amlodipine; clinical relevance of a unique pharmacokinetic profile J Cardiovasc Pharmacol 1993 22 (Suppl A) S6–S8

    Google Scholar 

  8. Dougall HT, McLay J A comparative review of the adverse effects of calcium antagonists Drug Saf 1996 15 91–106

    Article  CAS  Google Scholar 

  9. Turner S, Longworth A, Nunn AJ, Choonara I Unlicensed and off label drug use in paediatric wards: prospective study BMJ 1998 316 343–345

    Article  CAS  Google Scholar 

  10. Blumer JL Off-label drug use in children Pediatrics 1999 104 598–602

    CAS  PubMed  Google Scholar 

  11. Christensen ML, Helms RA, Chesney RW Is pediatric labeling really necessary? Pediatrics 1999 104 593–597

    CAS  PubMed  Google Scholar 

  12. Pfammatter JP et alAmlodipine once-daily in systemic hypertension Eur J Pediatr 1998 157 618–621

    Article  CAS  Google Scholar 

  13. Schwartz GJ, Haycock GB, Spitzer A Plasma creatinine and urea concentration in children: normal values for age and sex J Pediatr 1976 88 828–830

    Article  CAS  Google Scholar 

  14. High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents Pediatrics 1996 98 649–658

    Google Scholar 

  15. Guidlines Subcommittee 1999 World Health Organization—International Society of Hypertension Guidelines for the Management of Hypertension Blood Press Suppl 1999 1 9–43

    Google Scholar 

  16. Noll G, Lüscher TF Comparative pharmacological properties among calcium channel blockers: T-channel versus L-channel blockade Cardiology 1998 89 (Suppl 1) 10–15

    Article  Google Scholar 

  17. Scholz H Pharmacological aspects of calcium channel blockers Cardiovasc Drugs Ther 1997 10 (Suppl 3) 869–872

    Article  Google Scholar 

  18. Flynn JT, Smoyer WE, Bunchman TE Treatment of hypertensive children with amlodipine Am J Hypertens 2000 13 1061–1066

    Article  CAS  Google Scholar 

  19. Crawford JD, Terry ME, Rourke GM Simplification of drug dosage calculation by application of the surface area principle Pediatrics 1950 5 783–790

    CAS  PubMed  Google Scholar 

  20. Khattak S et alEfficacy of amlodipine in pediatric bone marrow transplantpatients Clin Pediatr (Phila) 1998 37 31–35

    Article  CAS  Google Scholar 

  21. Silverstein DM et alUse of calcium-channel blockers in pediatric renal transplant recipients Pediatr Transplant 1999 3 288–292

    Article  CAS  Google Scholar 

  22. Tallian KB et alEfficacy of amlodipine in pediatricpatients with hypertension Pediatr Nephrol 1999 13 304–310

    Article  CAS  Google Scholar 

  23. Rogan JW et alA randomized prospective crossover trial of amlodipine in pediatric hypertension Pediatr Nephrol 2000 14 1083–1087

    Article  CAS  Google Scholar 

  24. Schrama YC, Koomans HA Interactions of cyclosporin A and amlodipine: blood cyclosporin A levels, hypertension and kidney function J Hypertens 1998 16 (Suppl 6) 33–38

    Google Scholar 

  25. Nahata MC, Morosco RS, Hipple TF Stability of amlodipine besylate in two liquid dosage forms J Am Pharm Assoc (Wash) 1999 39 375–377

    Article  CAS  Google Scholar 

  26. Flynn JT, Pasko DA Calcium channels blockers:pharmacology and place in therapy of pediatric hypertension Pediatr Nephrol 2000 15 302–316

    Article  CAS  Google Scholar 

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Correspondence to MG Bianchetti.

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von Vigier, R., Franscini, L., Bianda, N. et al. Antihypertensive efficacy of amlodipine in children with chronic kidney diseases. J Hum Hypertens 15, 387–391 (2001). https://doi.org/10.1038/sj.jhh.1001203

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