Oral propranolol treatment safety in infantile hemangiomas

Infantile hemangiomas are common and can be treated with propranolol. Cardiovascular side effects are a potential risk of propranolol treatment. We assessed real-world propranolol side effects to help guide safe use of propranolol for infantile hemangiomas.

This is a descriptive cross-sectional study using retrospectively collected data from patients' electronic medical records from 2015 to 2023, with a sample of 64 patients. Patients diagnosed with infantile hemangiomas, who received oral propranolol, were included in the study. Data regarding the clinical features of the hemangiomas, oral propranolol dosing regimen, treatment response, adverse effects, and rebound hemangioma rate was collected.

Seventy percent of the hemangiomas were less than 10 cm² in size. Adverse effects were uncommon. The most common adverse effects were hyperkalemia, hypotension, and nightmares, which accounted for 23%, 9%, and 9% of patients, respectively. After treatment, 81% of the hemangiomas completely resolved, 8% demonstrated partial improvement, and 8% exhibited no improvement. The rate of rebound hemangiomas was 3%.

The majority of patients with infantile hemangioma can be safely managed with oral propranolol in an outpatient setting.