Oral Propranolol for Hemangiomas of Infancy

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

Disclosures

Pediatr Pharm. 2010;16(8) 

In This Article

Adverse Effects

Treatment with oral propranolol has been well tolerated in most of the cases of infantile hemangioma published to date. The primary adverse effects reported with propranolol use in infants have been somnolence, hypotension, bradycardia, bronchospasm, and hypoglycemia.[14] These reactions typically respond to dose reduction and may not require discontinuation of therapy. Lawley and colleagues reported lethargy, bradycardia, and hypotension in an 8-week-old infant with an eyelid hemangioma after two doses of propranolol and hypoglycemia (with a blood glucose level of 48 mg/dL) after 10 days of propranolol in a 36-day-old infant with multiple hemangiomas.[15] Both infants were being treated with an oral propranolol dose of 2 mg/kg/day.

Bonifazi and colleagues reported severe hypoglycemia and a resultant seizure upon waking in an infant who had been received oral propranolol 2 mg/kg/day for 5 months to treat diffuse hemangiomatosis.[16] The patient was hospitalized and closely monitored, but no further episodes occurred. Propranolol was restarted the following day at 1.5 mg/kg/day. The patient was able to continue treatment for another 5 months without further adverse effects.

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