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EFFECTIVENESS OF FIXED DOSES OF PROPRANOLOL IN THE TREATMENT OF HEMANGIOMAS REGARDLESS OF CHILD'S WEIGHT GAIN: A CASE
Jaime Anger1, Eduardo Mesquita de Oliveira1, José Gabel2
1Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Insights
Fixed-dose propranolol tablets effectively treated infant hemangiomas. Maintaining a consistent dose, despite weight changes, led to significant improvement and remission, avoiding rebound effects.
Area of Science:
- Pediatric dermatology
- Pharmacology
Background:
- Infantile hemangiomas are common benign vascular tumors.
- Treatment options for infantile hemangiomas have evolved.
- Propranolol is a key medication for treating problematic hemangiomas.
Observation:
- Two infants under six months received fixed-dose propranolol therapy.
- Tablets were crushed and diluted due to lack of oral solution.
- Dosage was not adjusted for weight gain.
Findings:
- Both patients showed significant improvement within 60 days.
- Complete remission was achieved by the end of treatment.
- Fixed dosing, without weight adjustment, proved effective.
Implications:
- Fixed-dose propranolol tablets can be a viable treatment option.
- This method may help prevent rebound effects and complications.
- Further research into fixed-dose propranolol for hemangiomas is warranted.
Objective:
To present the outcomes of fixed doses of propranolol tablets for the treatment of hemangiomas.
Case Description:
Two illustrative cases of hemangioma in infant patients younger than six months old are described. Treatments were started in 2010 and 2011 and were monitored until August 2017. Patients were treated with fixed doses, initially calculated based on the upper limit of 3 mg/kg/day and administrated in two daily doses rounded down to the nearest multiple of five milligrams. Dosage was not adjusted to patients' weight gain. The tablets were crushed and then diluted in a maximum amount of 3 mL of water. This procedure was necessary because propranolol was not available in oral solution in 2009, when dosages available in the Brazilian market were 10, 40 and 80 mg. Both patients presented significative improvement in the first 60 days and were in complete remission by the end of the treatment.
Comments:
It is possible to treat patients with Propranolol 10 mg tablets, even though the dosage is not as precise as when calculated according to patients' weight. The maintenance of a fixed dose, ignoring the patient's progressive weight gains, helps avoiding the rebound effect and decreases complications.
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