PROPRANOLOL FOR HEMANGIOMAS

Exclusion Criteria

Dosing

Protocol

Special Situations

Preemies

In a study of infants < 8 weeks with a corrected gestational age of range -11 weeks to 8 weeks, a slight increased risk of side effects was found. Five percent had serious side effects.

Side Effects to Worry About Most

Pivotal Study

This prospective, randomized trial of 460 infants showed that propranolol was effective at a dose of 3 mg per kilogram per day for 6 months in the treatment of infantile hemangioma [N Engl J Med. 2015 Feb 19;372(8):735-46.]. But note, most experts go to 2 mg/kg/day.

The frequency of successful treatment was higher with this regimen than with placebo (60% vs. 4%, P<0.001). A total of 88% of patients who received the selected propranolol regimen showed improvement by week 5, versus 5% of patients who received placebo. A total of 10% of patients, in whom treatment with propranolol was successful, required systemic retreatment during followup. Known adverse events associated with propranolol (hypoglycemia, hypotension, bradycardia, and bronchospasm) occurred infrequently, with no significant difference in frequency between the placebo group and the groups receiving propranolol.

Treatment with propranolol was not associated with developmental risk or growth impairment at 4 years of age [JAAD 2016;75;59].

Predictors of Rebound Growth

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