Propranolol for hemangioma

How does this medicine work?

Propranolol (pro-pran-oh-lol) is a beta-blocker medication. It is used to treat high blood pressure, heart rhythm problems, migraine headaches, and anxiety. It has also been used successfully to treat infantile hemangioma.

Propranolol typically works very quickly and most families notice improvement within a few days.

How should I give it?

Propranolol comes in liquid form. Give it at regular times to keep a steady level in the bloodstream. Doses need to be separated by at least 3-4 hours.

Your child should be awake and alert when taking any medicine. Follow the checked instructions below:

___ Shake well right before using. Draw up the correct amount in the medicine dropper or oral syringe. Give a small squirt of the medicine inside the cheek. To avoid choking, let your child swallow each squirt before giving more.

___ You may want to mix the medicine with a small amount of formula or breast milk and give it with a bottle nipple before feeding. Do not add the medicine to a whole bottle because if your baby does not finish it, you will not know how much of the medicine was taken.

Do not mix medicine into hot drinks, because the heat may destroy its effectiveness.

Are there any precautions about food or other medicines?

You may give propranolol with or without food, but try to give it the same way each time.

Some drugs may increase the effects of propranolol, such as alcohol, cimetidine, haldol, and other blood pressure or heart medications.

Some drugs may decrease the effects of propranolol, such as aluminum hydroxide, dilantin, phenobarbital, and rifampin.

Check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines.

What should I do if a dose is missed?

If a dose is missed, give it as soon as you remember, unless it is less than 3-4 hours until the next dose. In that case, skip the missed dose and continue with the regular schedule. Never give a double dose or give doses too close together.

If your child vomits (throws up) within 30 minutes after receiving a dose, give it again. If your child vomits the second dose, do not repeat it again.

If your child misses or vomits more than one dose, please call the clinic.

What are the side effects?

Occasional

Diarrhea
Gassiness/spitting up
Sleepiness
Night terrors
Cool hands/feet

Rare

Low blood sugar
Low blood pressure
Low heart rate

When should I call the clinic?

Call the clinic if:

your child is sleeping more
your child is not feeding well
the hemangioma is growing
signs of allergic reaction:
- rash or hives
- wheezing
- trouble breathing - call 911

What else do I need to know?

You should know the names and doses of all medicines your child is taking. Share this information with anyone involved in your child's care. Please bring the medicine container when your child comes to the clinic or emergency department.

Always make sure you have enough medicine on hand. Each time you refill the prescription, check to see how many refills are left. If no refills are left the pharmacy will need 2 or 3 days to contact the clinic to renew the prescription.

Before giving the first dose, read the label. Be sure it is what was prescribed. After a refill, if the medicine looks different to you, ask your pharmacist about it before giving it.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines. If there is no "take-back" program empty them into the trash.

Store all medicines in their original containers and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children's reach, locked up if possible.

If too much or the wrong kind of medicine is taken, call the Poison Control Center toll-free at 1-800-222-1222. If your child is unconscious or has a seizure, call 911.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call your clinic or pharmacy.

This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit www.childrensmn.org/educationmaterials.