Oral Propranolol for Hemangiomas of Infancy

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


Pediatr Pharm. 2010;16(8) 

In This Article


Propranolol is well absorbed after oral administration, but undergoes significant first-pass metabolism by the liver. Peak plasma concentrations occur 1–4 hours after an oral dose. Administration with protein-rich foods increases bioavailability. Propranolol is highly protein bound (90%); in adults, the volume of distribution is approximately 4–5 L/kg. It is extensively metabolized via aromatic hydroxylation, N-dealkylation, and direct glucuronidation to primarily inactive metabolites. Propranolol is a substrate for cytochrome P450 (CYP) 2D6 and 1A2. It is a weak inhibitor of CYP2D6. The average elimination half-life in adults is 2–6 hours.[2,3]


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