Oral Propranolol for Hemangiomas of Infancy

Marcia L. Buck, Pharm.D., FCCP, FPPAG


Pediatr Pharm. 2010;16(8) 

In This Article

Mechanism of Action

Within hours of starting therapy, propranolol produces vasoconstriction, resulting in a reduction in the color of the hemangioma. Its primary effect, however, appears to be alteration in the progression of angiogenesis in the hemangioma. Regulation of hemangioma growth involves basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF). Léauté-Labréze and colleagues theorized that propranolol may decrease expression of bFGF and VEGF. Based on examination of hemangioma tissue, Truong and coworkers have also speculated that beta-adrenergic antagonists may ablate catecholamine receptor signaling, decreasing cyclic AMP and reducing levels of VEGF. In addition, propranolol may promote involution of hemangiomas by triggering apoptosis in endothelial cells.[1,6]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: