BNF for Children (BNFC) 2018-2019

Mannitol 50 g/ 250 ml ( 20 %) infusion Viaflex bags| 1 bagPs

Mannitol 100 g/ 500 ml ( 20 %) infusion Viaflo bags| 1 bagPs

DIURETICS›POTASSIUM-SPARING DIURETICS

Amiloride hydrochloride

lINDICATIONS AND DOSE

Adjunct to thiazide or loop diuretics for oedema in heart

failure, and hepatic disease (where potassium

conservation desirable)

▶BY MOUTH

▶Neonate: 100 – 200 micrograms/kg twice daily.

▶Child 1 month–11 years: 100 – 200 micrograms/kg twice

daily; maximum 20 mg per day

▶Child 12–17 years: 5 – 10 mg twice daily

lUNLICENSED USENot licensed for use in children.

lCONTRA-INDICATIONSAddison’s disease.anuria.

hyperkalaemia

lCAUTIONSDiabetes mellitus

lINTERACTIONS→Appendix 1 : potassium-sparing diuretics

lSIDE-EFFECTSAlopecia.angina pectoris.aplastic anaemia

.appetite decreased.arrhythmia.arthralgia.asthenia.

atrioventricular block exacerbated.bladder spasm.chest

pain.confusion.constipation.cough.depression.

diarrhoea.dizziness.drowsiness.dry mouth.dyspnoea.

dysuria.electrolyte imbalance.encephalopathy.

gastrointestinal discomfort.gastrointestinal disorders.

gastrointestinal haemorrhage.gout.headache.insomnia.

jaundice.muscle cramps.nasal congestion.nausea.

nervousness.neutropenia.pain.palpitations.

paraesthesia.postural hypotension.sexual dysfunction.

skin reactions.tinnitus.tremor.vertigo.visual

impairment.vomiting

lPREGNANCYNot to be used to treat gestational

hypertension.

lBREAST FEEDINGManufacturer advises avoid—no

information available.

lRENAL IMPAIRMENTManufacturers advise avoid in severe

impairment.

MonitoringMonitor plasma-potassium concentration

(high risk of hyperkalaemia in renal impairment).

lMONITORING REQUIREMENTSMonitor electrolytes.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug. Forms available from special-order

manufacturers include: oral suspension, oral solution

Oral solution

EXCIPIENTS:May contain Propylene glycol

▶Amiloride hydrochloride (Non-proprietary)

Amiloride hydrochloride 1 mg per 1 mlAmiloride 5 mg/ 5 ml oral

solution sugar free sugar-free| 150 mlP£ 37. 35 DT = £ 37. 35

Tablet

▶Amiloride hydrochloride (Non-proprietary)

Amiloride hydrochloride 5 mgAmiloride 5 mg tablets|

28 tabletP£ 13. 99 DT = £ 3. 24

DIURETICS›THIAZIDES AND RELATED

DIURETICS

eiiiiF 110

Chlortalidone

(Chlorthalidone)

lINDICATIONS AND DOSE

Ascites|Oedema in nephrotic syndrome

▶BY MOUTH

▶Child 5–11 years: 0. 5 – 1 mg/kg every 48 hours (max. per

dose 1. 7 mg/kg every 48 hours), dose to be taken in the

morning

▶Child 12–17 years:Up to 50 mg daily

Hypertension

▶BY MOUTH

▶Child 5–11 years: 0. 5 – 1 mg/kg every 48 hours (max. per

dose 1. 7 mg/kg every 48 hours), dose to be taken in the

morning

▶Child 12–17 years: 25 mg daily, dose to be taken in the

morning, then increased if necessary to 50 mg daily

Stable heart failure

▶BY MOUTH

▶Child 5–11 years: 0. 5 – 1 mg/kg every 48 hours (max. per

dose 1. 7 mg/kg every 48 hours), dose to be taken in the

morning

▶Child 12–17 years: 25 – 50 mg daily, dose to be taken in

the morning, then increased if necessary to

100 – 200 mg daily, reduce to lowest effective dose for

maintenance

lINTERACTIONS→Appendix 1 : thiazide diuretics

lSIDE-EFFECTS

▶Common or very commonAppetite decreased.dizziness.

electrolyte imbalance.erectile dysfunction.

gastrointestinal discomfort.hyperglycaemia.

hyperuricaemia.skin reactions

▶UncommonGout

▶Rare or very rareAgranulocytosis.alkalosis

hypochloraemic.arrhythmia.diabetes mellitus

exacerbated.diarrhoea.eosinophilia.glycosuria.hepatic

disorders.nausea.nephritis tubulointerstitial.

pancreatitis.paraesthesia.photosensitivity reaction.

pulmonary oedema.respiratory disorder.vomiting

lBREAST FEEDINGThe amount present in milk is too small

to be harmful. Large doses may suppress lactation.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug. Forms available from special-order

manufacturers include: oral suspension

Tablet

▶Chlortalidone (Non-proprietary)

Chlortalidone 25 mgChlortalidone 25 mg tablets|

100 tabletPs

Chlortalidone 50 mgChlortalidone 50 mg tablets| 30 tabletP

£ 90. 55 DT = £ 88. 04

eiiiiF 110

Metolazone

lINDICATIONS AND DOSE

Oedema resistant to loop diuretics in heart failure, renal

disease and hepatic disease|Pulmonary oedema|

Adjunct to loop diuretics to induce diuresis

▶BY MOUTH

▶Child 1 month–11 years: 100 – 200 micrograms/kg

1 – 2 times a day

▶Child 12–17 years: 5 – 10 mg once daily, dose to be taken

in the morning; increased if necessary to 5 – 10 mg

twice daily, dose increased in resistant oedema

lUNLICENSED USENot licensed for use in children.

142 Oedema BNFC 2018 – 2019

Cardiovascular system

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