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Safety of propranolol for infantile hemangioma in infants less than five weeks corrected age
Jorie E Gatts1, Marie C Rush2, Jennifer F Check1
1Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Insights
Propranolol is safe and effective for treating infantile hemangiomas (IHs) in infants younger than 5 weeks corrected age. This study found no serious adverse events in this vulnerable population.
Area of Science:
- Pediatric Dermatology
- Neonatal Medicine
- Pharmacology
Background:
- Infantile hemangiomas (IHs) are common vascular tumors in infants.
- Propranolol is a standard treatment for problematic IHs.
- Safety data for propranolol in very young infants (<5 weeks corrected age) is limited.
Purpose of the Study:
- To evaluate the safety and efficacy of propranolol for IH treatment in infants under 5 weeks corrected age (or <45 weeks corrected gestational age).
Main Methods:
- Retrospective review of 24 infants treated with propranolol before 45 weeks corrected gestational age (CGA).
- Data collected included patient demographics, hemangioma characteristics, dosing, side effects, and treatment response.
- Treatment duration and outcomes were analyzed.
Main Results:
- 92% of infants showed clear benefit from propranolol at doses of 1-3 mg/kg/day.
- Common side effects included sleep disturbance (21%), irritability (17%), and cool extremities (13%).
- No serious adverse events were reported in this cohort.
Conclusions:
- Propranolol demonstrated safety and efficacy in treating infantile hemangiomas in infants under 5 weeks corrected age.
- Larger, prospective studies are recommended to further investigate propranolol use in this specific infant population.
Background/Objectives:
Propranolol is used to treat problematic infantile hemangiomas (IHs), but its safety in infants <5 weeks corrected age has not been established. The objective of this study was to assess the safety and efficacy of propranolol for treatment of IH in infants <5 weeks corrected age, or 45 weeks corrected gestational age (CGA).
Methods:
We performed a single institution, retrospective review of patients treated with propranolol prior to the age of 6 months between 2017 and 2021. Patient characteristics, location of hemangioma(s), weight at initiation of treatment, dosing information, side effects, response, and duration of treatment were documented.
Results:
Of 200 patients with IH treated with propranolol, 24 started treatment prior to 45 weeks CGA. Mean CGA at initiation of treatment was 42 weeks. Sixty-seven percent were female and 75% were white, non-Hispanic. Mean duration of treatment was 255 days. Twenty-two patients (92%) had clear benefit from treatment at a dose of 1-3 mg/kg/day. The most common side effects were sleep disturbance (21%), irritability (17%), and cool hands/feet (13%). There were no serious adverse events.
Conclusions:
In this cohort of 24 patients with corrected age <5 weeks (CGA <45 weeks), propranolol was safe and effective for the treatment of infantile hemangiomas. Larger, prospective studies are indicated to investigate propranolol in this age group.
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