title: β-blockers for infantile hemangiomas: a single-institution experience.
abstract: Propranolol has become first-line therapy for the treatment of infantile hemangiomas in many centers. Of 302 children with hemangiomas seen at the University of North Carolina from 2008 through 2010, 15.6% were treated with oral propranolol alone, 5.6% with topical timolol (a propranolol derivative) alone, and 2.3% with both. The use of these agents increased over time from 7% of patients seen in 2008 to 54% of patients first seen in 2010. Starting doses of propranolol ranged from 0.25 to 1 mg/kg/d, with target doses of 1 to 4 mg/kg/d. Serious side effects, noted in 6/54 (10.9%) patients, included somnolence, bradycardia, hypotension, hypoglycemia, and mottling of extremities.The authors confirm the variation in use of propranolol for vascular lesions and extend experience with timolol. They suggest daily home monitoring of patients for the first 2 weeks of initiating or increasing doses. Frequent feeding of infants and young children on this drug is recommended.
authors.affiliation: University of North Carolina School of Medicine and the University of North Carolina School of Medicine Vascular Anomalies Clinic, Chapel Hill, NC, USA. jblat@med.unc.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Blatt
authors.forename: Dean S
authors.initials: DS
authors.lastname: Morrell
authors.forename: Scott
authors.initials: S
authors.lastname: Buck
authors.forename: Carlton
authors.initials: C
authors.lastname: Zdanski
authors.forename: Stuart
authors.initials: S
authors.lastname: Gold
authors.forename: Joseph
authors.initials: J
authors.lastname: Stavas
authors.forename: Cynthia
authors.initials: C
authors.lastname: Powell
authors.forename: Craig N
authors.initials: CN
authors.lastname: Burkhart
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D016903:Drug Monitoring; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000188:drug therapy; D008113:Liver Neoplasms / Q000188:drug therapy; D008297:Male; D011433:Propranolol / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D013999:Timolol / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000319:Adrenergic beta-Antagonists; D013999:Timolol; D011433:Propranolol