Effect of Bisoprolol as a β-Adrenoceptor Antagonist for Pediatric Patients

Bisoprolol (Maintate®), a highly β1-selective antagonist, is effective in adults !for a 24-hour period with a daily oral administration 5mg . There are few reports on the use ofbisoprolol in children.We administered this agent to children with hypertension, angina, or arrythmias aloneor concomitantly.Thirteen patients aged 5 to 20 years old were recruited for this study . Bisoprolol wasgiven to the patients over 15 years old at a dose of 5mg after breakfast, while to thoseunder 14 years old, a dose of 2. 5mg twice a day was given . The correlation of the blood.concentration at 4 hours after administration and the dose, tmax, t1/2 was compared with thatin adults. Laboratory analyses of hematology and blood chemistry were also conducted beforeand after administration. No abnormal changes in laboratory data were observed.The correlation o⊥ blood level Y (ng/ml) and the dose per weight X (mg/kg) wassignificant (Y=5.211+223.8X, r= 0.744, p<0.05). The optimal daily dose for children is0. 08mg/kg. Although there was no significant difference in tmax between children and adults, t1/2 in children (5.7 ±1.5hr) was significantly shorter than in adults (8 . 6 ± 1.0hr).Bisoprolol was clinically effective in 11 patients. However, one patient developed bradycardia due to an overdose. The dose should be adjusted according to the patient's weight .It is, therefore, recommendable to administer bisoprolol twice a day in children.