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Copyright @ Pol J Cosmetol
 
ISSN 1731-0083
Friday, 29.03.2024
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Pol J Cosmetol 2019, 22(1): 25-30pladd to cart

Propranolol - an old drug and new indications in infantile hemangioma managemnet


Martyna Waliczek 1/, Damian Nowak 2/, Aleksandra Kulik 1/, Sylwia Duda 1/, Eva Korossy-Mruk 3/, Przemysław Nowak 3/

1/ Zakład Toksykologii i Ochrony Zdrowia w Środowisku Pracy, Katedra Toksykologii i Uzależnień, Wydział Zdrowia Publicznego w Bytomiu, Śląski Uniwersytet Medyczny w Katowicach
2/ Katedra i Zakład Fizjologii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
3/ Zakład Farmakologii, Collegium Medicum, Uniwersytet Opolski

Summary
Infantile hemangiomas (IH) are the most common vascular tumor of infancy affecting approximately 5% to 10% of the childhood population. Typically, IH are innocuous and characterized by a proliferative rapid growth phase, which starts after a few weeks of life, followed by spontaneous involution. In general, they do not represent a potential risk for health and do not require therapy, but in some cases (10-15%), systemic therapy should be promptly initiated. The above applies to IH causing heart failure or respiratory distress, IH posing functional risks, e.g., visual obstruction, amblyopia or feeding problems and severe anatomic distortion, especially on the face and neck. Available treatments like oral corticosteroids and chemotherapeutic agents are not always satisfactory and are encumbered by potential serious side effects. From an accidental discovery made by is by Leaute-Labreze in 2008, the nonselective β-adrenoceptor blocker - propranolol emerged as an alternative therapy and it instantaneously became a first-line treatment for this disorder. Propranolol is a drug that has long been used in children for cardiac indications. The suggested dose of this drug given orally in IH treatment is 2 to 3 mg/kg/day. Propranolol poses some risk of bradycardia and systemic hypotension; it may also exacerbate reactive airway disease and masks symptoms of hypoglycemia but previous clinical experience in children population indicate that it is well tolerated and side-effects are rare.

Key words: propranolol, beta-blockers, infantile hemangioma, treatment