Propranolol for infantile haemangiomas: experience from a tertiary center

• Published in: Journal of cutaneous and aesthetic surgery Vol. 7; no. 1; pp. 37 - 41
• Main Authors: Pandey, Vaibhav, Tiwari, Preeti, Gangopadhyay, Ajay N, Gupta, Dinesh K, Sharma, Shiv P, Kumar, Vijayendar
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-01-2014; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd
• Subjects: Case studies; Children; Diseases; Dosage and administration; Drug therapy; Health aspects; Hemangioma; Original; Propranolol hydrochloride; Adverse effects; infantile haemangiomas; ulcerated haemangiomas; propranolol
• ISSN: 0974-2077; 0974-5157
• DOI: 10.4103/0974-2077.129975

Infantile haemangiomas are the most common tumor of infancy. We report the use of propranolol for treatment of problematic and complicated haemangiomas.
Propranolol was given to 52 children with mean age of 18.2 months at onset of treatment. After clinical and electrocardiographic evaluations, propranolol was administered with a starting dose of 2 mg/kg per day, given in 3 divided doses. Monthly follow up was done, response to oral propranolol therapy and any complications of therapy were recorded. Response to propranolol was classified as Complete Response, Excellent Response, Partial Response and Non Responder.
Total 49 patients showed significant improvement after propranolol therapy out of which 4 patients were complete responder, 30 patients (56.7%) were excellent responders; 15 patients (28.8%) were partial responders. 3 patients (5.7%) had growth of haemangiomas despite propranolol therapy and were classified as non-responder. Side effect like hypotension, rashes, gastroesophageal reflux was reported by 3 patients. In our study mean duration of treatment was 6.5 months. At the end of treatment propranolol was stopped by with gradual tapering of dose over a period of 2 weeks.
Propranolol administered orally at 2 mg/kg per day has rapid effective therapeutic effect in treatment of ulcerated haemangiomas and it appears to be a valuable and effective treatment option for infantile haemangiomas beyond the proliferative phase, and esthetically disfiguring haemangiomas.