title: Nadolol for the treatment of infantile hemangioma.
abstract: OBJECTIVE
  The successful use of nadolol as an alternative to propranolol therapy in three cases of infantile hemangioma is reported.
  
  
  CONCLUSIONS
  Infantile hemangioma is a benign vascular neoplastic disorder that affects up to 10% of newborns and can lead to deformity or local complications in severe cases. Propranolol, administered alone or in combination with corticosteroids, is increasingly used to treat infantile hemangioma, but its ability to cross the blood-brain barrier and potentially cause central nervous system adverse effects has prompted research on alternative β-blocker therapies for the disorder that have more favorable safety profiles, including nadolol. This article describes the use of nadolol to treat three pediatric patients with a buccal or genital hemangioma who developed adverse reactions (mainly, irritability and sleep disturbances) or resistance to initial treatment with propranolol. The patients were 10 months, 12 months, and 4 years of age, respectively, when hemangioma treatment was initiated. The results of nadolol therapy were favorable, with involution of lesions and gradual disappearance of propranolol-associated adverse effects occurring in all three cases. As with any use of β-blocker therapy in a pediatric patient, a cardiac workup is advised before the start of nadolol therapy; blood pressure and heart rate monitoring should be performed at one and two hours after the first dose and continued during dose escalation.
  
  
  CONCLUSIONS
  Nadolol was an effective alternative to propranolol in three pediatric patients with hemangiomas.
authors.affiliation: Angela M. Villalba-Moreno is Pharmacist, Jesus Cotrina-Luque is Pharmacist, Concepcion Alvarez Del Vayo-Benito is Pharmacist, Sandra Flores-Moreno is Pharmacist, and Francisco J. Bautista-Paloma is Pharmacist, Department of Pharmacy, University Hospital Virgen del Rocío, Seville, Spain. angelavm_21@hotmail.com.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Villalba-Moreno
authors.affiliation: Angela M. Villalba-Moreno is Pharmacist, Jesus Cotrina-Luque is Pharmacist, Concepcion Alvarez Del Vayo-Benito is Pharmacist, Sandra Flores-Moreno is Pharmacist, and Francisco J. Bautista-Paloma is Pharmacist, Department of Pharmacy, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Cotrina-Luque
authors.affiliation: Angela M. Villalba-Moreno is Pharmacist, Jesus Cotrina-Luque is Pharmacist, Concepcion Alvarez Del Vayo-Benito is Pharmacist, Sandra Flores-Moreno is Pharmacist, and Francisco J. Bautista-Paloma is Pharmacist, Department of Pharmacy, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Concepcion Alvarez
authors.initials: CA
authors.lastname: Del Vayo-Benito
authors.affiliation: Angela M. Villalba-Moreno is Pharmacist, Jesus Cotrina-Luque is Pharmacist, Concepcion Alvarez Del Vayo-Benito is Pharmacist, Sandra Flores-Moreno is Pharmacist, and Francisco J. Bautista-Paloma is Pharmacist, Department of Pharmacy, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Flores-Moreno
authors.affiliation: Angela M. Villalba-Moreno is Pharmacist, Jesus Cotrina-Luque is Pharmacist, Concepcion Alvarez Del Vayo-Benito is Pharmacist, Sandra Flores-Moreno is Pharmacist, and Francisco J. Bautista-Paloma is Pharmacist, Department of Pharmacy, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Bautista-Paloma
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D009248:Nadolol / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D009248:Nadolol; D011433:Propranolol