Amlodipine Dosing for a 3-Year-Old Weighing 10.3 kg
For this 10.3 kg child, start amlodipine at 1.0 mg once daily (0.1 mg/kg/day), which can be titrated up to a maximum of 2.5 mg daily based on response. 1
Weight-Based Dosing Calculation
The American Heart Association and American Thoracic Society guidelines specify a starting dose of 0.1–0.3 mg/kg/day for pediatric amlodipine. 1
For this 10.3 kg child:
For a child this size (10.3 kg), the practical starting dose is 1.0 mg once daily, with potential titration to 2.5 mg daily if needed. 1
Administration Guidelines
Always uptitrate from the lower dose to minimize adverse effects, particularly in young children. 1
Amlodipine should be administered once daily due to its long half-life (36-60 hours in adults), which provides 24-hour coverage. 2, 3
The onset of effect is gradual over 4-8 hours after dosing, with steady-state achieved after 1-1.5 weeks of daily administration. 2
Key Safety Considerations
Monitor for bradycardia, decreased cardiac output, and peripheral edema as these are the primary adverse effects in pediatric patients. 1
Additional side effects to watch for include rash, gum hyperplasia, and constipation. 1
Duration of benefit may be limited even with initial favorable response; periodic repeat assessments for responsiveness are indicated. 1
Critical Dosing Pitfalls
Never exceed 2.5 mg daily initially in a child this size (10.3 kg), as the maximum pediatric dose range is 2.5-7.5 mg/day total, and this child is at the lower end of the weight spectrum. 1
The adult maximum dose of 10 mg/day does not apply to pediatric patients and should not be used as a reference point. 1
Start low and go slow - the gradual onset of action (4-8 hours) means you won't see immediate effects, so resist the urge to increase the dose too quickly. 2