Usual Adult Dose for Hypertensive Emergency

0.01 to 0.3 mcg/kg/min IV as a continuous infusion; may increase by 0.05 to 0.1 mcg/kg/min every 15 minutes or longer until target blood pressure is reached.

Maximum dose: 1.6 mcg/kg/min

Duration of therapy: Maintenance infusions may be continued for up to 48 hours.

Comments:

• Doses lower than 0.1 mcg/kg/min and slow up-titration have been associated with less reflex tachycardia.
• Oral antihypertensives can be added any time after blood pressure is stable during infusion of this drug.

Usual Pediatric Dose for Hypertensive Emergency

Less than 1 month (at least 2 kg or full term) to 12 years:
0.2 mcg/kg/min IV as a continuous infusion; may increase by 0.3 to 0.5 mcg/kg/min every 20 to 30 minutes to maximum dose

Maximum dose: 0.8 mcg/kg/min

Duration of therapy: Maintenance infusions may be continued for up to 4 hours.

Comments: In general, doses greater than 0.8 mcg/kg/min produced no further decreases in mean arterial pressure (MAP) but did worsen tachycardia.

Use: In-hospital, short-term reduction in blood pressure.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Safety and efficacy have not been established in patients 13 to 17 years old.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice: The manufacturer product information should be consulted.

Storage requirements:

• Store at 2 to 30C (35.6 to 86F).
• Discard diluted solution if not administered after 4 hours at room temperature or 24 hours at refrigerated temperature.

• Metabolic: Serum potassium

• Advise patients to contact a healthcare professional immediately if they experience neurological symptoms, visual changes, or evidence of congestive heart failure.
• Inform patients with underlying hypertension that they require continued follow-up of their medical condition, and, if appropriate, encourage them to continue their antihypertensive treatment as directed.