BNF for Children 2011-2012

BNFC 2011–2012 2.4 Beta-adrenoceptor blocking drugs 89Child 12–18 years initially 80 mg twice daily;increased at weekly intervals as required; maintenance160–320 mg daily; slow-release preparationsmay be used for once daily administrationTetralogy of Fallot. By mouthNeonate 0.25–1 mg/kg 2–3 times daily, max.2 mg/kg 3 times dailyChild 1 month–12 years 0.25–1 mg/kg 3–4 timesdaily, max. 5 mg/kg daily. By slow intravenous injection with ECG monitoringNeonate initially 15–20 micrograms/kg (max.100 micrograms/kg), repeated every 12 hours ifnecessaryChild 1 month–12 years initially 15–20 micrograms/kg(max. 100 micrograms/kg), repeatedevery 6–8 hours if necessary; higher doses rarelynecessaryMigraine prophylaxis. By mouthChild 2–12 years initially 200–500 micrograms/kg twice daily; usual dose 10–20 mg twice daily;max. 2 mg/kg twice dailyChild 12–18 years initially 20–40 mg twice daily;usual dose 40–80 mg twice daily; max. 2 mg/kg(max. 120 mg) twice dailyAdministration for slow intravenous injection, giveover at least 3–5 minutes; rate of administrationshould not exceed 1 mg/minute. May be diluted withSodium Chloride 0.9% or Glucose 5%. Incompatiblewith bicarbonate.Note Excessive bradycardia can be countered with intravenousinjection of atropine sulphate; for overdosage seeEmergency Treatment of Poisoning, p. 29Propranolol (Non-proprietary) ATablets, propranolol hydrochloride 10 mg, net price28-tab pack = 92p; 40 mg, 28-tab pack = 93p; 80 mg,56-tab pack = £1.54; 160 mg, 56-tab pack = £4.02.Label: 8Brands include Angilol cOral solution, propranolol hydrochloride 5 mg/5 mL,net price 150 mL = £12.50; 10 mg/5 mL, 150 mL =£16.45; 50 mg/5 mL, 150 mL = £19.98. Label: 8Brands include Syprol cInderal c (AstraZeneca) AInjection, propranolol hydrochloride 1 mg/mL, netprice 1-mL amp = 21pModified releaseNote Modified-release preparations for once daily administration;use in older children onlyHalf-Inderal LA c (AstraZeneca) ACapsules, m/r, lavender/pink, propranolol hydrochloride80 mg. Net price 28-cap pack = £5.40.Label: 8, 25Note Modified-release capsules containing propranololhydrochloride 80 mg also available; brands include BedranolSR c , Half Beta Prograne cInderal-LA (AstraZeneca) ACapsules, m/r, lavender/pink, propranolol hydrochloride160 mg. Net price 28-cap pack = £1.91.Label: 8, 25Note Modified-release capsules containing propranololhydrochloride 160 mg also available; brands includeBedranol SR c , Beta-Prograne c , Slo-Pro cATENOLOLCautions see under Propranolol HydrochlorideContra-indications see under Propranolol HydrochlorideRenal impairment initially use 50% of usual dose ifestimated glomerular filtration rate 10–35 mL/minute/1.73m 2 ; initially use 30–50% of usual dose ifestimated glomerular filtration rate less than 10 mL/minute/1.73 m 2Pregnancy see notes aboveBreast-feeding see notes aboveSide-effects see under Propranolol HydrochlorideLicensed use not licensed for use in children under12 yearsIndication and doseHypertension. By mouthNeonate 0.5–2 mg/kg once daily; may be given in2 divided dosesChild 1 month–12 years 0.5–2 mg/kg once daily(doses higher than 50 mg daily rarely necessary);may be given in 2 divided dosesChild 12–18 years 25–50 mg once daily (higherdoses rarely necessary); may be given in 2 divideddosesArrhythmias. By mouthNeonate 0.5–2 mg/kg once daily; may be given in2 divided dosesChild 1 month–12 years 0.5–2 mg/kg once daily(max. 100 mg daily); may be given in 2 divideddosesChild 12–18 years 50–100 mg once daily; may begiven in 2 divided dosesAtenolol (Non-proprietary) ATablets, atenolol 25 mg, net price 28-tab pack = 83p;50 mg, 28-tab pack = 86p; 100 mg, 28-tab pack = 91p.Label: 8Tenormin c (AstraZeneca) A‘25’ tablets, f/c, atenolol 25 mg, net price 28-tab pack= £1.16. Label: 8LS tablets, orange, f/c, scored, atenolol 50 mg, netprice 28-tab pack = £2.04. Label: 8Tablets, orange, f/c, scored, atenolol 100 mg, netprice 28-tab pack = £3.46. Label: 8Syrup, sugar-free, atenolol 25 mg/5 mL, net price300 mL = £8.55. Label: 8CARVEDILOLCautions see under Propranolol Hydrochloride;monitor renal function during dose titration in childrenwith heart failure who also have low blood2 Cardiovascular system