4 mg/kg daily in divided doses, ongoing doses should
only be given if test dose tolerated
▶Child 1–11 years:Test dose 100 micrograms/kg (max. per
dose^6.^25 mg), monitor blood pressure carefully for
1 – 2 hours; usual dose 100 – 300 micrograms/kg
2 – 3 times a day, then increased if necessary up to
6 mg/kg daily in divided doses, ongoing doses should
only be given if test dose tolerated
▶Child 12–17 years:Test dose 100 micrograms/kg,
alternatively test dose 6. 25 mg, monitor blood pressure
carefully for 1 – 2 hours; usual dose 12. 5 – 25 mg
2 – 3 times a day, then increased if necessary up to
150 mg daily in divided doses, ongoing doses should
only be given if test dose tolerated
Diabetic nephropathy in type 1 diabetes mellitus
▶BY MOUTH
▶Child 12–17 years (under expert supervision):Test dose
100 micrograms/kg, alternatively test dose 6. 25 mg,
monitor blood pressure carefully for 1 – 2 hours; usual
dose 12. 5 – 25 mg 2 – 3 times a day, increased if
necessary up to 100 mg daily in divided doses, ongoing
doses should only be given if test dose toleratedlUNLICENSED USENot licensed for proteinuria in nephritis.
Captopril doses in BNF Publications differs from product
licence.
lCAUTIONSChildren (efficacy and safety not fully
established)
lINTERACTIONS→Appendix 1 : ACE inhibitors
lSIDE-EFFECTS
▶Common or very commonEpigastric discomfort.peptic
ulcer
▶UncommonAppetite decreased.flushing.malaise.pallor.
postural hypotension.Raynaud’s phenomenon
▶Rare or very rareAlveolitis allergic.anaemia.aplastic
anaemia.autoimmune disorder.cardiac arrest.
cardiogenic shock.cerebrovascular insufficiency.
depression.gynaecomastia.hypoglycaemia.
lymphadenopathy.nephrotic syndrome.oliguria.oral
disorders.proteinuria.urinary disorders.vision blurred
lBREAST FEEDINGAvoid infirst few weeks after delivery,
particularly in preterm infants—risk of profound neonatal
hypotension; can be used in mothers breast-feeding older
infants if essential but monitor infant’s blood pressure.
lDIRECTIONS FOR ADMINISTRATIONAdminister under close
supervision. Give test dose whilst child supine. Tablets can
be dispersed in water.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Captopril for heart failure
http://www.medicinesforchildren.org.uk/captopril-heart-failure- 0
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet, capsule, oral suspension, oral
solution
Tablet
▶Captopril (Non-proprietary)
Captopril 12.5 mgCaptopril 12. 5 mg tablets| 56 tabletP£ 2. 80
DT = £ 2. 06 | 100 tabletP£ 5. 00
Captopril 25 mgCaptopril 25 mg tablets| 56 tabletP£ 4. 52 DT =
£ 0. 56 | 100 tabletP£ 8. 07
Captopril 50 mgCaptopril 50 mg tablets| 56 tabletP£ 5. 83 DT =
£ 2. 15 | 100 tabletP£ 10. 41
▶Ecopace(AMCo)
Captopril 12.5 mgEcopace 12. 5 mg tablets| 56 tabletP£ 0. 48
DT = £ 2. 06
Captopril 25 mgEcopace 25 mg tablets| 56 tabletP£ 0. 60 DT =
£ 0. 56
Captopril 50 mgEcopace 50 mg tablets| 56 tabletP£ 0. 72 DT =
£ 2. 15
Oral solution
ELECTROLYTES:May contain Sodium
▶Noyada(Martindale Pharmaceuticals Ltd)
Captopril 1 mg per 1 mlNoyada 5 mg/ 5 ml oral solution sugar-free|
100 mlP£ 98. 21 DT = £ 98. 21
Captopril 5 mg per 1 mlNoyada 25 mg/ 5 ml oral solution sugar-free
| 100 mlP£ 108. 94 DT = £ 108. 94eiiiiF 111Enalapril maleate
lINDICATIONS AND DOSE
Hypertension
▶BY MOUTH
▶Neonate (under expert supervision):Initially
10 micrograms/kg once daily, monitor blood pressure
carefully for 1 – 2 hours, increased if necessary up to
500 micrograms/kg daily in 1 – 3 divided doses, limited
information.▶Child 1 month–11 years (under expert supervision):Initially
100 micrograms/kg once daily, monitor blood pressure
carefully for 1 – 2 hours, then increased if necessary up
to 1 mg/kg daily in 1 – 2 divided doses
▶Child 12–17 years (under expert supervision) (body-weight
up to 50 kg):Initially 2. 5 mg once daily, monitor blood
pressure carefully for 1 – 2 hours, maintenance
10 – 20 mg daily in 1 – 2 divided doses
▶Child 12–17 years (under expert supervision) (body-weight
50 kg and above):Initially 2. 5 mg once daily, monitor
blood pressure carefully for 1 – 2 hours, maintenance
10 – 20 mg daily in 1 – 2 divided doses; maximum 40 mg
per day
Heart failure
▶BY MOUTH
▶Neonate (under expert supervision):Initially
10 micrograms/kg once daily, monitor blood pressure
carefully for 1 – 2 hours, increased if necessary up to
500 micrograms/kg daily in 1 – 3 divided doses, limited
information.▶Child 1 month–11 years (under expert supervision):Initially
100 micrograms/kg once daily, monitor blood pressure
carefully for 1 – 2 hours, then increased if necessary up
to 1 mg/kg daily in 1 – 2 divided doses
▶Child 12–17 years (under expert supervision) (body-weight
up to 50 kg):Initially 2. 5 mg once daily, monitor blood
pressure carefully for 1 – 2 hours, maintenance
10 – 20 mg daily in 1 – 2 divided doses
▶Child 12–17 years (under expert supervision) (body-weight
50 kg and above):Initially 2. 5 mg once daily, monitor
blood pressure carefully for 1 – 2 hours, maintenance
10 – 20 mg daily in 1 – 2 divided doses; maximum 40 mg
per day
Proteinuria in nephritis (under expert supervision)
▶BY MOUTH
▶Neonate:Initially 10 micrograms/kg once daily, monitor
blood pressure carefully for 1 – 2 hours, increased if
necessary up to 500 micrograms/kg daily in 1 – 3 divided
doses, limited information.▶Child 1 month–11 years:Initially 100 micrograms/kg once
daily, monitor blood pressure carefully for 1 – 2 hours,
then increased if necessary up to 1 mg/kg daily in
1 – 2 divided doses
▶Child 12–17 years (body-weight up to 50 kg):Initially
2. 5 mg once daily, monitor blood pressure carefully for
1 – 2 hours, maintenance 10 – 20 mg daily in 1 – 2 divided
doses
▶Child 12–17 years (body-weight 50 kg and above):Initially
2. 5 mg once daily, monitor blood pressure continued→BNFC 2018 – 2019 Hypertension 113
Cardiovascular system2