Propranolol is a medicine from the class of beta-blockers. It has been used in the treatment of high blood pressure and other medical conditions for decades. Since 2008 it has also been used off-license for the treatment of complicated infantile are small and hidden; once they have reached their full size, they can be expected to slowly shrink over the next few years. However, propranolol should be considered when there is a risk of a complication. Indications for treatment include infantile softens (decrease in volume) and darkens in colour. The optimal duration of treatment is yet to be established, though most reports are of use for 3-12 months. Rebound growth may occur on cessation and gradual weaning may be required. Propranolol may also be effective if it is started after the growth phase, even over the age of 12 months. Despite not being licensed for the treatment of infantile hemangiomas (IH) in infants younger than 5 weeks or older than 5 months, propranolol is often used in these age groups to prevent or to treat potentially severe complications. The objective of the present study was to review the experience of 8 Italian pediatric and dermatologic centers regarding propranolol treatment for IH started before 5 weeks or after 5 months of age. Treatment complications were reported in 15.8% of children, most frequently sleep disorders (6.6%), followed by irritability (5.1%) and diarrhea (2.2%). We retrospectively reviewed the records of patients followed up for IH, on propranolol treatment started before 5 weeks or after 5 months of age, and collected information on sociodemographic data, treatment indications, IH involution, IH relapse, and treatment side effects. Only a case of mild constipation was observed in group 1. A total of 343 patients were enrolled; 15 were started on propranolol before 5 weeks (group 1), 328 were started after 5 months of age (group 2). The safety and effectiveness profile of propranolol in infants younger than 5 weeks or older than 5 months may be acceptable. The most frequent indications were permanent aesthetical disfigurement (91.8%) and function threatening complications (42.6%). Taking in account propranolol's potential in preventing severe complications, further studies should assess the acceptability of propranolol treatment, especially in the ]. The natural history of IHs is characterized by an onset within the first weeks of life, followed by a proliferative phase with rapid growth, generally lasting until 5 months of age; in some cases, the proliferative phase may last up to 10-11 months . In 10-15% of cases, a treatment is required, with the following indications: life threatening complications, function threatening complications, ulceration not responding to local treatments, pain and potential permanent disfigurement .
Jun 27, 2017. Propranolol, is a nonselective beta-blocker and if not contraindicated, stands as the first-line agent for hemangiomas that impair function or. May 29, 2018. In 2010, oral propranolol was approved for treatment of infantile hemangiomas under a compassionate use protocol by the French Regulatory.