title: What can we do to make antihypertensive medications taste better for children?
abstract: More and more data indicate the importance of palatability when selecting drugs for children. Since hypertension is uncommon in children, no child-friendly palatable formulations of these agents are currently available. As a consequence, in everyday practice available tablets are crushed and administered mixed with food or a sweet drink. We started investigating the issue of palatability of drugs among children in 2004 using smile-face scales. In the first trial we compared taste and smell acceptability of pulverized angiotensin receptor antagonists among nephropathic children and found that the score assigned to candesartan was significantly higher than that assigned to irbesartan, losartan, telmisartan and valsartan. In the second trial we compared the taste of pulverized amlodipine and lercanidipine among children and found that the score assigned to lercanidipine was significantly higher. Our third trial was performed using pulverized β-adrenoceptor blockers, angiotensin-converting enzyme inhibitors, calcium-channel antagonists and diuretics among medical officers and pediatricians. The palatability scores assigned to chlorthalidone, hydrochlorothiazide and lisinopril were significantly higher to those assigned to atenolol, bisoprolol, enalapril and ramipril. In conclusion pulverized amlodipine, atenolol, bisoprolol, enalapril, irbesartan, losartan, ramipril, telmisartan and valsartan are poor tasting. From the child's perspective, lercanidipine, candesartan, chlorthalidone, hydrochlorothiazide and lisinopril are preferable.
authors.affiliation: Integrated Department of Paediatrics, Ente Ospedaliero Cantonale Ticinese, and University of Berne, Switzerland.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ferrarini
authors.forename: Alesandra A
authors.initials: AA
authors.lastname: Bianchetti
authors.forename: Emilio F
authors.initials: EF
authors.lastname: Fossali
authors.forename: Pietro B
authors.initials: PB
authors.lastname: Faré
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
authors.forename: Sebastiano A G
authors.initials: SA
authors.lastname: Lava
authors.forename: Mario G
authors.initials: MG
authors.lastname: Bianchetti
mesh_terms: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D002648:Child; D004232:Diuretics; D006801:Humans; D009812:Odorants; D013649:Taste
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics
keywords: Angiotensin II type 1 receptor antagonists; Angiotensin-converting enzyme inhibitors; Arterial hypertension calcium-channel antagonists; Childhood palatability; Thiazide diuretics; β-Adrenoceptor blockers