Initial experience with isradipine for the treatment of hypertension in children

Background. Isradipine is a calcium channel blocker of the dihydropyridine class. It has limited effects on myocardial contractility; is available in a powder-filled capsule and has a half-life of 6 to 8 hours. Methods. Pharmacy records were reviewed to identify pediatric patients who had received isradipine. The following demographic data were obtained: age, weight, sex, underlying medical problems, and initial blood pressure value s. Information concerning isradipine included the initial dose and its inte rval, subsequent dose escalations, blood pressure response to the medicatio n, and duration of therapy. Results. The study population comprised 12 patients, ranging in age from 10 days to 11 years. The etiology of the hypertension was renal in 9 cases an d nonrenal in 3. Initial dosing with isradipine was 0.1 mg/kg/dose. Six pat ients had emergent hypertension, and their blood pressure had been controll ed with intravenous nicardipine before oral isradipine. Six patients receiv ed initial therapy with oral isradipine. Isradipine was monotherapy in 7 pa tients and in combination with other agents in 5 patients. The dose of isra dipine required for blood pressure control was 0.6 +/- 0.3 mg/kg/day (range , 0.3 to 1.2 mg/kg/day). Isradipine failed to provide effective blood press ure control in 9 patients. In 1 of these patients, isradipine was effective after peritoneal dialysis. Conclusions. Isradipine is an effective, orally administered agent for cont rol of hypertension in children.