How are infants monitored during treatment with propranolol for infantile hemangiomas?

Updated: Feb 06, 2019
  • Author: Richard J Antaya, MD; Chief Editor: William D James, MD  more...
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Answer

Monitoring 1 and 2 hours after administration (dosing) includes the following:

  • Blood pressure check
  • Heart rate check (hold dose for heart rate at
  • Blood glucose level (because of the potential for blocking of liver glycogen phosphorylase) only for inpatients; recommended that young infants feed every 3-4 hours to decrease risk of hypoglycemia
  • Temperature determination to evaluate for hypothermia
  • Observation for bronchospasm
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    At home, parents should observe for signs of lethargy, poor feeding, and/or bronchospasm.

    Blood pressure and heart rate should be evaluated intermittently at the pediatrician's office.

    Note that practices vary considerably.

    Discontinuation

    Consider a gradual taper over 2 weeks, rather than abrupt discontinuation. Cardiac hypersensitivity may occur 24-48 hours after propranolol is discontinued (peaks at 4-8 d).


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