From the Guidelines
Captopril dosing for infants should be initiated at 0.3–0.5 mg/kg per dose, with a maximal dose of 6 mg/kg per day, administered three times a day (TID) 1. The dosing range is based on the infant's age, with the provided dose range applicable for infants over 12 months.
- The initial dose should be adjusted based on the infant's clinical response and blood pressure monitoring.
- It is essential to monitor serum potassium and creatinine levels periodically to detect potential hyperkalemia and azotemia 1.
- Captopril is contraindicated in pregnancy, and women of childbearing age should use reliable contraception 1.
- The medication can be compounded into a suspension, which may be necessary for infant administration 1. Key considerations in captopril administration for infants include:
- Starting at the lower end of the dosing range and gradually titrating upward as needed and based on clinical response.
- Administering the medication 1 hour before or 2 hours after feedings to minimize the impact of food on absorption.
- Regularly monitoring blood pressure, renal function, serum potassium, and white blood cell count during treatment. The mechanism of action of captopril involves inhibiting angiotensin-converting enzyme (ACE), which reduces the production of angiotensin II, a potent vasoconstrictor, thereby decreasing peripheral vascular resistance and blood pressure 1.
From the Research
Dosing Range of Captopril for Infants
- The dosing range of Captopril for infants is not strictly defined, but various studies provide some guidance:
- A study from 2006 2 mentions that daily doses of Captopril range from 0.3 to 1.5 mg/kg in children, but does not specify the dosing range for infants.
- A study from 1984 3 reports dosages of Captopril varying between 0.5 and 11.0 mg/kg BW in children, but this range may not be applicable to infants.
- A study from 1990 4 reports the use of Captopril in newborn infants with doses of 0.1-0.2 mg/kg/day.
- A study from 1986 5 found that neonates responded to significantly lower doses of Captopril (0.01-0.5 mg/kg).
- A study from 2008 6 reports an initial median dose of Captopril of 0.17 mg/kg/day, slowly increased over 3-33 days to a maximal median dose of 1.86 mg/kg/day in newborn and young infants.
Key Considerations
- The dosing range of Captopril for infants may vary depending on the specific clinical condition and the patient's response to the medication.
- It is essential to monitor infants on Captopril for potential side effects, including renal impairment, low blood pressure, and oxygen saturation deficit 6.
- The dosage of Captopril should be adjusted based on the patient's response and tolerance to the medication, and under the guidance of a qualified healthcare professional.