Finil Dosage/Direction for Use

Hypertension: Note: Antihypertensive effect usually observed within 2 weeks; maximum antihypertensive effect seen within 4 to 6 weeks. Consider lower initial dosages in volume depleted patients; if possible, correct volume depletion prior to administration.
Use in children <6 years is not approved in the Canadian labeling.
Children 1 to <6 years: Oral: Initial: 0.2 mg/kg/day in 1 to 2 divided doses; titrate to response; usual range: 0.05 to 0.4 mg/kg/day; maximum daily dose: 0.4 mg/kg/day.
Children ≥6 years and Adolescents <17 years: Oral: U.S labeling: <50 kg: Initial: 4 to 8 mg daily in 1 to 2 divided doses; titrate to response; usual range: 2 to 16 mg daily; maximum daily dose: 32 mg daily.
≥50 kg: Initial: 8 to 16 mg daily in 1 to 2 divided doses; titrate to response; usual range: 4 to 32 mg daily; maximum daily dose: 32 mg daily.
Canadian labeling: <50 kg: Initial: 4 mg once daily; titrate to response; maximum dose: 8 mg daily.
50 kg: Initial: 8 mg once daily; titrate to response; maximum dose: 16 mg daily.
Adults: Oral: Dosage must be individualized. Initial: 16 mg once daily; titrate to response; usual range: 8 to 32 mg daily in 1 to 2 divided doses; target dose: 12 to 32 mg daily; maximum daily dose: 32 mg daily.
Heart failure: Adults: Oral: Initial: 4 mg once daily (U.S. labeling) or alternatively 4 to 8 mg once daily (ACCF/AHA); double the dose at 2-week intervals as tolerated; target dose: 32 mg once daily (ACCF/AHA).
Note: Concurrent therapy with an ACE inhibitor may provide additional benefit in patients with HF with reduced EF who remain symptomatic on standard therapy and are unable to receive an aldosterone antagonist (ACCF/AHA).
Canadian labeling: Initial: 4 mg once daily; double the dose at 2-week intervals as tolerated; target dose: 32 mg once daily Elderly: No initial dosage adjustment is necessary for elderly patients (although higher concentrations (C_max) and AUC were observed in this population).
Dosage adjustment in renal impairment: U.S. labeling: Children ≥1 year and Adolescents <17 years: There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Children with GFR <30 mL/minute/1.73 m^₂ should not receive cande­sartan.
Adults: No initial dosage adjustment necessary; how­ever, in patients with severe renal impairment (CrCl <30 ml/minute/1.73 m²) AUC and C_max were approx­imately doubled after repeated dosing.
Canadian labeling: Children ≥6 and Adolescents ≤17 years: There are no dosage adjustments provided in manufacturer's label­ing (has not been studied).
Adults: Mild impairment: No dosage adjustment necessary.
Moderate or severe impairment: Consider initial dose of 4 mg once daily in patients with hypertension.
Dialysis: Consider initial dose of 4 mg once daily in patients with hypertension.
Dosage adjustment in hepatic impairment: U.S. labeling: Mild impairment (Child-Pugh class A): No initial dosage adjustment necessary.
Moderate impairment (Child-Pugh class B): Initial: 8 mg daily (AUC increased by 145%) in adult patients with hypertension. There are no dosage adjustments pro­vided in the manufacturer's labeling for pediatric patients.
Severe impairment (Child-Pugh class C): There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); however, systemic exposure increases significantly in moderate impairment.