Underdosing of antiretrovirals in UK and Irish children with HIV as an example of problems in prescribing medicines to children, 1997-2005: cohort study
BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7551.1183 (Published 18 May 2006) Cite this as: BMJ 2006;332:1183Data supplement
Table 1 Recommended antiretroviral dosing for children aged 2-12 years used in this analysis8
Table 1 Recommended antiretroviral dosing for children aged 2-12 years used in this analysis8Growth
parameterMinimum recommended daily dose8
Maximum daily
dose prescribed (usually adult dose)
Weight / SA at which maximum dose
reached
Median age of children in CHIPS
at weight/SA for maximum dose
(years)
NRTI
zidovudine
m2
360mg/m2
600mg
1.67m2
14.7
lamivudine
kg
8mg/kg
300mg
37.5kg
11.9
abacavir
kg
16mg/kg
600mg
37.5kg
11.9
didanosine
m2
180mg/m2 *
400mg if >60kg
400mg
2.22m2
60kg
16.8
15.0stavudine
kg
2mg/kg
60mg if 30-60kg80mg if >60kg
80mg
60kg
15.0
tenofovir
kg
6mg/kg
300mg
50kg
13.9
NNRTI
nevirapine
m2
300mg/m2 *
400mg
1.33m2
12.6
efavirenz
kg
12.5mg/kg †
600mg
48kg
13.2
PI
lopinavir
/ritonavirm2
460/115mg/m2 *‡
800/200mg
1.74m2
15.4
nelfinavir
kg
110mg/kg
2500mg
22.7kg
7.3
ritonavir
m2
700mg/m2
1200mg
1.71m2
15.1
* the lower limit of the range of doses included in guidelines
† approximate dose for weight, based on the more complex formula 600*(weight/70)0.7 used in the original study11. Higher doses are recommended for syrup (approx 15mg/kg), and licensed dosing is based on weight bands (corresponding to a wider range of doses per kilo): 13-<15kg 200mg, 15-<20kg 250mg, 20-<25kg 300mg, 25-<32.5kg 350mg, 32.5-40kg 400mg, >40kg 600mg. Formulation data are not collected in CHIPS.
‡ higher doses are recommended if taken concurrently with NNRTI.
Note: shaded boxes denote current best dose where approved paediatric dose has not yet been licensed. SA = surface area.
Committees and participants (alphabetical):
CHIPS Steering Committee: K Butler, K Doerholt, D Dunn, T Duong, D Gibb, H Lyall, J Masters, E Menson, V Novelli, C Peckham, A Riordan, M Sharland, P Tookey, G Tudor-Williams, G Wait
National Study of HIV in Pregnancy & Childhood, Institute of Child Health: Janet Masters, Catherine Peckham, Pat Tookey
MRC Clinical Trials Unit: D Dunn, T Duong, L Farrelly, D Gibb, D Johnson, E Menson, G Wait, AS Walker
We thank the staff, families & children from the CHIPS centres:
Republic of Ireland: Our Lady's Hospital for Sick Children, Dublin: K Butler, M O'Meara, A Walsh
UK: Heartlands Hospital, Birmingham: A Riordan; Bristol Royal Hospital for Children, Bristol: A Finn, A Foot, L Hutchison, Ninewells Hospital and Medical School, Dundee: T Lornie; Ealing Hospital, Middlesex: K Sloper, V Shah; Royal Edinburgh Hospital for Sick Children, Edinburgh: J Mok; Great Ormond St Hospital for Children, London: DM Gibb, V Novelli, N Klein, S Fasolo, M Clapson, B Ohene-Kena, J Flynn, K Moshal; King's College Hospital, London: C Ball, D Nayagam, S Hawkins; Newham General Hospital, London: S Liebeschuetz, E Cooper, D Shingadia, T Fisher, S Wong, Northampton General Hospital, Northhampton: F Thompson; Royal Free Hospital, London: V Van Someren, S McKenna; St George's Hospital, London: M Sharland, R Chakraborty, S Donaghy, S Storey, C Wells; St Mary's Hospital, London: G Tudor-Williams, H Lyall, S Walters, S Campbell, C Hanley, C Walsh; St Thomas' Hospital, London: G Du Mont, R Cross; University Hospital Lewisham, London: J Stroobant; John Radcliffe Hospital, Oxford: A Pollard, S Segal; Sheffield Children's Hospital, Sheffield: F Shackley, J Hobbs; Chelsea and Westminster Hospital, London: H Lyall, P Seery; North Middlesex Hospital, London: H Lyall, J Daniels, B Sampson-Davis; University Hospital of Wales, Cardiff: B O' Hare; Royal London Hospital, London: D Shingadia, B Ramaboea; Northwick Park Hospital, Middlesex: A Williams, M Le Provost; Central Middlesex Hospital, London: A Williams, M Le Provost; Wexham Park, Slough: R Jones
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