Propranolol For The Treatment Of Haemangiomas - What is it for

Propranolol is now widely used for the treatment of haemangiomas. However, it may not be suitable for all infants/children. Your doctor will determine if your child is suitable for treatment with propranolol as he/she will require monitoring before, during and after treatment.

What Is Propranolol and How Does It Work?
Propranolol is a beta-blocker. It blocks a chemical called noradrenaline. Noradrenaline stimulates the heart to pump faster and harder. Propranolol blocks noradrenaline causing the heart to pump slower and less vigorously. Propranolol also makes blood vessels tighter, reducing the amount of blood flowing through them. This contributes to making haemangiomas smaller. However, more research is still needed to fully validate how propranolol works on haemangiomas.

Side-effects of propranolol
Propranolol may rarely be associated with some side-effects. If your child experiences any of the symptoms below, inform your doctor immediately. The doctor may reduce the dose or stop the use of propranolol. The possible side effects of propranolol are:

Slow heart rate (bradycardia)
Low blood pressure (hypotension)
Narrowing of the airway, which may lead to wheezing and difficulty breathing (brochospasm)
Weakness and fatigue
Sleep disturbance and nightmares
Hyperactivity
Low blood glucose levels (hypoglycemia)
Cool hands and feet

What tests are required before starting propranolol?
All infants and children will require an Electrocardiogram (ECG) before starting on propranolol. A baseline heart rate and blood pressure will be recorded. Photographs of the haemangiomas will be taken for recording purposes. Other tests, including heart echocardiogram (2DE), MRI or CT scans may be ordered by your doctor depending on the site, size and number of haemangiomas. Infants with other significant medical conditions may be admitted to the paediatric ward to commence treatment if required.

What should I look out for when taking propranolol?
Propranolol is taken orally. The dose prescribed will depend on the weight of your child. It is given either twice or thrice daily. Your pharmacist will inform you on the amount and frequency of the medication. Please follow these instructions carefully. As propranolol can cause low blood glucose levels, please ensure that you give the dose of propranolol only after your child’s usual feed. If your child is not feeding well for various reasons (e.g. illness), please omit the scheduled dose of propranolol until your child’s appetite has recovered.

Seek immediate medical attention if your child experiences: