Amlodipine in pediatric patient with uncontrolled multifactorial hypertension. Formulation of amlodipine oral suspension

N. Lago Rivero, I. Arias Santos, A. Paradela Carreiro

Pharmacy Service, University of Vigo Hospital Complex (Xeral-Cíes), Vigo, Pontevedra, Spain. natividad.lago.rivero@sergas.es

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• Cardiology

OBJECTIVES: To describe the case of treatment with amlodipine in a poorly controlled hypertension in a pediatric patient diagnosed with tricodistrofia.

CASE SUMMARY: Girl 5 years old, diagnosed of tricodistrofia included within the Tay-Sachs syndrome.
As a consequence of a cardiac arrest suffered in the context of a respiratory distress syndrome associated with infection by influenza A, she developed hypertension initially treated with nifedipine and captopril.
After several months of treatment and a poor control of the hypertension, a change of treatment was decided, substituting nifedipine by amlodipine (2.5 mg/24 hours orally) and captopril by enalapril (2.5 mg/24 hours orally). Pharmacy service is request to get a amlodipine syrup that allows a dose adjustment to the needs of the patient.
After the change of treatment the patient begins to maintain diastolic blood pressure levels within the normal range, suspending the administration of enalapril, maintaining good control of blood pressure with amlodipine 2 mg/24 hours.

DISCUSSION: Most of antihypertensive drugs used in adults do not have clinical trials to evaluate its effects in the pediatric population. Furthermore, the lack of familiarity with the pharmacokinetic characteristics of the child, raises problems to adjust the dose to the changing reality of a child. In this situation, clinical experience supports the use of some of these drugs in children with optimal results. With the addition to the pediatric field of calcium antagonists and ACE-inhibitors or ARB-II, they allow as to have greater potential therapeutic alternatives.

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