Side Effects of propranolol (infantile hemangioma): A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Research Findings

Propranolol is widely used as an effective drug for the treatment of infantile hemangioma. Propranolol acts as a β-blocker, inhibiting the growth of infantile hemangioma by suppressing vascular constriction. However, the effects of propranolol on the brain are a concern. This is because propranolol is highly lipophilic and can cross the blood-brain barrier and accumulate in the brain. Some researchers have pointed out that propranolol can cause neurological side effects when it reaches the brain. 9

Many studies have confirmed that propranolol is effective in treating infantile hemangioma. 22

There are also research findings that propranolol is effective and safe for the treatment of infantile hemangioma. 10

There are research findings that propranolol is effective and safe for the treatment of infantile hemangioma, but there are also research findings that the dosage of propranolol varies from person to person. 24

Reasons for Side Effects

The side effects of propranolol are thought to be caused by β-blocking action. β-blocking action has the effect of lowering blood pressure by slowing the heartbeat or dilating blood vessels. These effects are thought to be the reason why propranolol can cause neurological side effects when it reaches the brain. 9

Common Side Effects

Hypotension

Hypotension is listed as a side effect of propranolol. 10

Bradycardia

Bradycardia is listed as a side effect of propranolol. 10

Hypoglycemia

Hypoglycemia is listed as a side effect of propranolol. 10

Breathing difficulties

Breathing difficulties are listed as a side effect of propranolol. 1

Sleep disturbance

Sleep disturbance is listed as a side effect of propranolol. 18

Countermeasures for Side Effects

Countermeasures for Hypotension

Countermeasures for hypotension caused by propranolol include reducing the dosage of propranolol or discontinuing the administration of propranolol. 10

Countermeasures for Bradycardia

Countermeasures for bradycardia caused by propranolol include reducing the dosage of propranolol or discontinuing the administration of propranolol. 10

Countermeasures for Hypoglycemia

Countermeasures for hypoglycemia caused by propranolol include reducing the dosage of propranolol or discontinuing the administration of propranolol. 10

Countermeasures for Breathing difficulties

Countermeasures for breathing difficulties caused by propranolol include reducing the dosage of propranolol or discontinuing the administration of propranolol. 1

Countermeasures for Sleep disturbance

Countermeasures for sleep disturbance caused by propranolol include reducing the dosage of propranolol or discontinuing the administration of propranolol. 18

Comparison between Studies

Commonalities between Studies

Many studies have confirmed that propranolol is effective in treating infantile hemangioma. However, the effects of propranolol on the brain are a concern. 9

Differences between Studies

The dosage and duration of propranolol administration vary from study to study. The side effects of propranolol also vary from study to study. 24

Precautions for Applying Research Findings to Real Life

Propranolol is an effective drug for the treatment of infantile hemangioma, but it also poses the risk of side effects. When taking propranolol, it is important to follow your doctor’s instructions and adhere to the proper dosage and duration of administration. 22

Limitations of Current Research

There is still insufficient research on the effects of propranolol on the brain. Further research is needed to investigate the effects of propranolol on the brain. 9

Future Research Directions

Research is needed to further investigate the effects of propranolol on the brain. Research is also needed to optimize the dosage and duration of propranolol administration. Further research is needed to reduce the side effects of propranolol. 9

Conclusion

Propranolol is an effective drug for the treatment of infantile hemangioma, but it also poses the risk of side effects. When taking propranolol, it is important to follow your doctor’s instructions and adhere to the proper dosage and duration of administration. Further research is needed on the effects of propranolol on the brain. 9

Literature analysis of 24 papers
Positive Content
24
Neutral Content
0
Negative Content
0
Article Type
0
2
3
3
22
2.

A Life Threatening Subglottic and Mediastinal Hemangioma in an Infant.

Author: OnderSerap Sahin, GerginOzgul, KarabulutBurak

Hemangioma treatment

This case report describes a 2-month-old infant with mediastinal and subglottic hemangioma who was successfully treated with propranolol without the need for tracheostomy or other surgical interventions. Propranolol is a safe and effective treatment for life-threatening infantile hemangiomas compressing the airway.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Oral Beta-blocker in Problematic Infantile Hemangioma.

Author: AlHasanRashed N, ArabiyatLamees, AmmarHamad M, LouriNayef A

Improved hemangioma response
None mentioned

Oral propranolol can be used safely and effectively to treat problematic infantile hemangiomas. This study reports on a young girl who successfully treated her hemangioma without surgery.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

5.

Safety of propranolol for infantile hemangioma in infants less than five weeks corrected age.

Author: GattsJorie E, RushMarie C, CheckJennifer F, SamelakDiane M, McLeanThomas W

IH treatment

This study assessed the safety and efficacy of propranolol for treatment of problematic infantile hemangiomas (IHs) in infants <5 weeks corrected age. Propranolol can be used safely and effectively to treat IHs in infants <5 weeks corrected age.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Non-beta blocker enantiomers of propranolol and atenolol inhibit vasculogenesis in infantile hemangioma.

Author: SeebauerCaroline T, GrausMatthew S, HuangLan, McCannAlex, Wylie-SearsJill, FontaineFrank, KarnezisTara, ZurakowskiDavid, StaffaSteven J, MeunierFrédéric, MullikenJohn B, BischoffJoyce, FrancoisMathias

Improved hemangioma treatment
None mentioned

Propranolol and atenolol are drugs used to treat infantile hemangioma (IH), a type of birthmark. The study found that a specific part of these drugs, called the R(+) enantiomer, can prevent the growth of blood vessels from IH cells. The R(+) enantiomer might be a safer and more effective treatment for IH.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Infantile Hemangioma Treated with Oral Propranolol: Case Presentation.

Author: RaufiNahid, NematArash

Growth phase
Infantile hemangiomas
Side effects

Propranolol, a beta-blocker, effectively treated the growth phase of infantile hemangiomas in a 6-month-old infant, leading to near resolution within 6 months.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

8.

Should Propranolol Remain the Gold Standard for Treatment of Infantile Hemangioma? A Systematic Review and Meta-Analysis of Propranolol Versus Atenolol.

Author: ChenTiffany, GudipudiRachana, NguyenShaun A, CarrollWilliam, ClemmensClarice

Complete response
Lower complete response
Side effects

Propranolol treatment led to a significantly higher rate of complete response than atenolol in infantile hemangioma. However, its use must be weighed against its greater side effect profile.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Efficacy and safety of propranolol cream in infantile hemangioma: A prospective pilot study.

Author: NagataEiko, KashiwaguraYasuharu, OkadaEisaku, TanakaShimako, SanoShinichiro, NishidaMitsuhiro, HayanoSatoshi, IwashimaSatoru, HakamataAkio, OdagiriKeiichi, InuiNaoki, WatanabeHiroshi, UmemuraKazuo, UchidaShinya

IH treatment efficacy
IH treatment safety

This multicenter pilot study evaluated the efficacy and safety of topical propranolol cream for infantile hemangioma (IH) in eight Japanese infants. The efficacy rate at week 24 was 68.8%, with a decrease in surface area, maximum diameter, and color intensity of the IH over time. The treatment was well-tolerated with no drug-related adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

11.

Diagnosis of infantile subglottic hemangioma and the effect of oral propranolol.

Author: ChenWei, ZhuPeng, XuMengrou, ChenShumei, WangYing, ShenChenling, XuHongming, ChenJiarui, LiXiaoyan

Propranolol benefits
SGH treatment

Oral propranolol was found to be safe and effective for treating infantile subglottic hemangioma (SGH) in 21 cases. Early diagnosis and treatment with propranolol were crucial for successful management.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Propranolol Therapy in Infantile Hemangioma: It Is Not Just About the Beta.

Author: LeeJames C, ModiriOmeed, EnglandRyan W, ShawberCarrie J, WuJune K

Hemangioma treatment
Treatment complications

Propranolol is a drug used to treat a type of birthmark, called infantile hemangiomas. Some children experience side effects from the drug, and their parents may consider surgery as an alternative treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

[Chinese experts consensus on the use of oral propranolol for treatment of infantile hemangiomas].

Author: ZhengJia-Wei, WangXu-Kai, QinZhong-Ping, FanXin-Dong, LiKai, YangYao-Wu, HuoRan, LiuShao-Hua, ZhaoJi-Hong, WangXiao-Yong, ZhouDe-Kai

Infantile hemangioma treatment
Side effects

This Chinese expert consensus provides guidance on the use of oral propranolol for the treatment of infantile hemangioma (IH), aiming to standardize treatment protocols and minimize complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Chinese

16.

Enhanced efficacy of propranolol therapy for infantile hemangiomas based on a mesoporous silica nanoplatform through mediating autophagy dysfunction.

Author: WuHaiwei, WangXuan, LiangHao, ZhengJiawei, HuangShengyun, ZhangDongsheng

Hemangioma treatment

This study investigated a propranolol delivery system based on mesoporous silica nanoparticles (PRN@MSN) for the treatment of infantile hemangiomas. PRN@MSN nanoparticles exhibited higher cytotoxicity compared with free propranolol and could induce excessive autophagosome accumulation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Management of infantile hemangiomas-experience of a tertiary hospital.

Author: GomesRita, SalazarLuís, FragaCarolina, CorreiaMário Rui, Barbosa-SequeiraJoana, FernandesAlexandre, ÁlvaresSílvia, Banquart LeitãoJosé, Paiva CoelhoMargarida

IH management
Propranolol efficacy
Sleep disturbance

This study describes the experience of a multidisciplinary team managing infantile hemangiomas (IH) in a tertiary hospital. Propranolol was used in one-third of patients, with a safe and feasible outpatient protocol, and most IH showed at least partial regression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Angiotensin-converting Enzyme Inhibitors: Can it be a Potential Treatment of Infantile Hemangioma.

Author: GuptaArchika, KureelShiv Narain, PandeyAnand, SinghGurmeet, KumarAkhilesh, ShandilyaGaurav, RaiRahul Kumar, GuptaSurvesh Kumar

IH involution
Allergic reaction
Slow response

Oral captopril, an angiotensin-converting enzyme (ACE) inhibitor, may have a role in the involution of infantile hemangiomas (IH). A prospective study of 18 children with IH found that 9 patients showed excellent response to captopril over 16-18 months, while 4 patients showed good response.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Safety of Oral Propranolol for the Treatment of Infantile Hemangioma: A Systematic Review.

Author: Léaute-LabrèzeChristine, BoccaraOlivia, Degrugillier-ChopinetCaroline, Mazereeuw-HautierJuliette, PreySorilla, LebbéGeneviève, GautierStéphanie, OrtisValérie, LafonMartine, MontagneAgnès, DelarueAlain, VoisardJean-Jacques

Effective IH treatment
Well tolerated
Agitation
Peripheral coldness
Sleep disturbance

Oral propranolol was found to be well tolerated in patients with infantile hemangioma.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Therapeutic efficacy of propranolol for infantile hemangiomas.

Author: WuWenli, WangHongtao, HaoJiansuo, GaoZijun, LiFan, ChenYiyang

IH treatment
Diarrhea

The effect of oral propranolol was better in younger patients. A 3- to 4.5-mg/kg/day dose may not be more effective than the conventional recommended dose of 2 to 3 mg/kg/day. The most common side effect was diarrhea (52.2%).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

The effectiveness and safety of topical β-receptor blocker in treating superficial infantile haemangiomas: A meta-analysis including 20 studies.

Author: LinZhenying, ZhangBaoxin, YuZhongjing, LiHuanyuan

Topical β-blockers for SIH

This meta-analysis of 20 studies found that topical beta-receptor blockers (propranolol and timolol) were as effective as oral propranolol in treating superficial infantile haemangiomas. Topical timolol was found to be more effective than topical imiquimod, observation, and topical saline solutions. Topical timolol was also associated with fewer adverse effects than oral propranolol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Efficacy of Propranolol Between 6 and 12 Months of Age in High-Risk Infantile Hemangioma.

Author: BaselgaEulalia, Dembowska-BaginskaBozenna, PrzewratilPrzemysław, González-EnseñatMaría Antonia, WyrzykowskiDariusz, TorreloAntonio, López GutiérrezJuan-Carlos, Rychłowska-PruszyńskaMagdalena, de Lucas-LagunaRaúl, Esteve-MartinezAltea, RoéEsther, ZaimMohammed, MenonYoann, GautierStéphanie, LebbéGeneviève, BouroubiAthmane, DelarueAlain, VoisardJean-Jacques

Efficacious retreatment
Increased success rate in high-risk IH
Sustained success after stopping treatment
Mild adverse events

Oral propranolol treatment for infantile hemangioma is effective when administered for a minimum of 6 months and up to 12 months of age. The success rate increased from 47% after 6 months to 76% at the end of the treatment period. Most patients sustained success for 3 months after stopping treatment. Retreatment was effective and the safety profile was satisfactory.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Individualized dosing of oral propranolol for treatment of infantile hemangioma: a prospective study.

Author: PrasadArun, SinhaAmit Kumar, KumarBindey, PrasadAbhiranjan, KumariManju

Hemangioma treatment

This study aimed to determine the appropriate dosage of oral propranolol for the treatment of infantile hemangioma.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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