Anemia of Prematurity - Portal Neonatal

Contraindications Documented hypersensitivity; renal impairment
Interactions
NSAIDs may reduce hypotensive effects of captopril; ACE inhibitors
may increase digoxin, lithium, and allopurinol levels; rifampin
decreases captopril levels; probenecid may increase captopril levels;
the hypotensive effects of ACE inhibitors may be enhanced when
administered concurrently with diuretics
Pregnancy D - Unsafe in pregnancy
Precautions
Drug Name
Adult Dose
Pediatric Dose
Pregnancy category D in second and third trimester, pregnancy
category C in first trimester; caution in renal impairment, valvular
stenosis, or severe congestive heart failure
Enalapril (Vasotec) -- Competitive inhibitor of ACE. Reduces
angiotensin II levels, decreasing aldosterone secretion.
1.25 mg (as enalaprilat)/dose IV over 5 min q6h; not to exceed 5
mg/dose
5-20 mg/d PO; not to exceed 40 mg/d
IV: Not recommended (see precautions)
PO: Not FDA approved for neonates; limited data exist, 0.08 mg/kg/d
PO qd initially; may increase gradually, not to exceed 0.6 mg/kg/d
Contraindications Documented hypersensitivity
Interactions
NSAIDs may reduce hypotensive effects of enalapril; ACE inhibitors
may increase digoxin, lithium, and allopurinol levels; rifampin
decreases enalapril levels; probenecid may increase enalapril levels;
the hypotensive effects of ACE inhibitors may be enhanced when
administered concurrently with diuretics
Pregnancy D - Unsafe in pregnancy
Precautions
Pregnancy category D in second or third trimester, pregnancy
category C in first trimester; the IV formulation is not recommended
in managing neonatal hypertension due to risk of acute renal failure
and oliguria; PO administration may be useful in the neonatal
hypertension long-term management
Drug Category: Diuretic agents -- Decrease plasma volume. Promote excretion of water and
electrolytes by the kidneys. May be used as monotherapy or combination therapy to treat
hypertension.
Drug Name
Chlorothiazide (Diuril) -- Inhibits reabsorption of sodium in distal
tubules, causing increased excretion of sodium and water as well as
potassium and hydrogen ions.
Adult Dose 0.5-1 g PO divided qd/bid
Pediatric Dose 5-15 mg/kg/dose PO bid
Contraindications Documented hypersensitivity; anuria
Interactions
Thiazides may decrease effects of anticoagulants, antigout agents,
and sulfonylureas; thiazides may increase toxicity of allopurinol,
anesthetics, antineoplastics, calcium salts, loop diuretics, lithium,
diazoxide, digitalis, amphotericin B, and nondepolarizing muscle
relaxants
Pregnancy D - Unsafe in pregnancy
Precautions
Caution in renal disease, hepatic disease, gout, diabetes mellitus,
and erythematosus