Safety of short-acting nifedipine in children with severe hypertension

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Joseph T Flynn1

  • 1Division of Paediatric Nephrology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA. jflynn@montefiore.org

Expert Opinion on Drug Safety
|August 9, 2003
PubMed

Insights

Short-acting nifedipine, while popular for pediatric severe hypertension, carries risks similar to adults. Lower doses may be safe, but alternative medications offer better blood pressure control and administration for most children.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Clinical Therapeutics

Background:

  • Short-acting nifedipine was withdrawn for adult severe hypertension due to adverse effects.
  • It remains a common treatment for severe hypertension in children.
  • Recent studies highlight similar adverse effects in children, prompting reevaluation.

Purpose of the Study:

  • To review the pharmacology, clinical efficacy, and safety of short-acting nifedipine in children.
  • To reassess the advisability of using short-acting nifedipine for pediatric severe hypertension.

Main Methods:

  • Literature review of available data on short-acting nifedipine.
  • Analysis of pharmacology, clinical efficacy, and safety profiles.
  • Reassessment of its use in pediatric severe hypertension.

Main Results:

  • Low doses (< 0.25 mg/kg) might be safe for some hypertensive children.
  • Adverse effects in children mirror those seen in adults.
  • Alternative agents offer more controlled blood pressure reduction and easier administration.

Conclusions:

  • The continued use of short-acting nifedipine in children with severe hypertension is questionable.
  • While low doses may be acceptable in select cases, alternatives are preferred for most pediatric patients.
  • Safer and more manageable antihypertensive agents should be prioritized for children.

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