Skip to Content
Merck
  • Treatment of infantile hemangiomas with propranolol: clinical guidelines.

Treatment of infantile hemangiomas with propranolol: clinical guidelines.

Plastic and reconstructive surgery (2013-12-20)
Pawel Szychta, Ken Stewart, Will Anderson
ABSTRACT

Infantile hemangioma is a vascular tumor and requires treatment in lesions manifested by potentially dangerous symptoms. Several publications have reported that involution of infantile hemangioma could be accelerated by propranolol but have used only invalidated subjective measures of assessment. The authors aimed to objectively validate the aesthetic results after propranolol treatment for infantile hemangioma, and to produce a therapy protocol, including optimal timing for introduction, pretreatment preparation, dosage, frequency of visits, duration, and patient safety. For the nonrandomized comparative cohort study, the authors enrolled 60 patients treated with propranolol. Medical two-dimensional photographs, taken before and after treatment, were subjectively analyzed by three plastic surgery consultants and objectively analyzed with a computer program. Aesthetic results were analyzed using the following parameters: subjective overall outcome, subjective color fading, and objective color fading. Reliability of subjective and objective methods was quantified and compared, as described with accuracy and repeatability. Volumetric parameters were obtained from three-dimensional scans taken before and after treatment and objectively analyzed with a computer program. Numerous patients' data were recorded from the medical notes. This study proved high efficiency of propranolol in treatment of infantile hemangioma, as assessed with the objective measures for the first time. The authors outlined an optimal treatment protocol, including introduction, dosage, duration, and cessation of therapy. Propranolol is an effective, well-tolerated, and safe first-line treatment for proliferative hemangioma. Therapy should begin early, continue with the target dosage of 2 mg/kg/day in three divided doses through the proliferative phase of infantile hemangioma, and be stopped gradually. Therapeutic, IV.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
(±)-Propranolol hydrochloride, ≥99% (TLC), powder
Supelco
Propranolol hydrochloride solution, 1.0 mg/mL in methanol (as free base), ampule of 1 mL, certified reference material, Cerilliant®
Supelco
(±)-Propranolol hydrochloride, analytical standard
Propranolol hydrochloride, European Pharmacopoeia (EP) Reference Standard
Supelco
Propranolol hydrochloride, Pharmaceutical Secondary Standard; Certified Reference Material
USP
Propranolol hydrochloride, United States Pharmacopeia (USP) Reference Standard