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| hemangioma_treatment [2018/07/30 03:04] – Scott Larson | hemangioma_treatment [2025/04/18 20:40] (current) – external edit 127.0.0.1 | ||
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| ===== Propranolol ===== | ===== Propranolol ===== | ||
| ==== Dosing ==== | ==== Dosing ==== | ||
| - | + | === Preferred Dosing === | |
| - | * 1 mg/kg/d divided | + | * 1 mg/kg/d divided |
| - | * 2 mg/kg/d divided | + | * 1.5 mg/kg/d divided |
| - | * 3 mg/kg/d divided TID or BID- keep at this dose (can increase with change in weight) | + | * 2 mg/kg/d divided BID keep at this dose |
| - | * Minimum | + | == Common Alternate dosing == |
| + | * 1 mg/kg/d divided TID for 1 week | ||
| + | * 1.5 mg/kg/d divided TID for 1 week | ||
| + | * 2 mg/kg/d divided TID keep at this dose | ||
| + | == French RCT Dosing == | ||
| + | * 1 mg/kg/d divided BID for 1 week | ||
| + | * 2 mg/kg/d divided BID for 1 week | ||
| + | * 3 mg/kg/d divided BID | ||
| + | === Other Considerations === | ||
| + | * Try for 6 hours between doses | ||
| * Hold if child can't take PO | * Hold if child can't take PO | ||
| * Child should not skip meals | * Child should not skip meals | ||
| - | * Typically use for minimum 6 months | + | * Typically use for minimum 6 months, 12 months have less recurrences |
| * When lesion treated, tapering is common to ensure no recurrence of the lesion | * When lesion treated, tapering is common to ensure no recurrence of the lesion | ||
| - | * Monitor Blood pressure and pulse 1 and 2 hours after any dose increase of >0.5 mg/kg/day) | + | * Monitor Blood pressure and pulse 1 and 2 hours after any dose increase of >0.5 mg/kg/day |
| ==== Pre-Treatment issues ==== | ==== Pre-Treatment issues ==== | ||
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| * if PHACE is suspected: MRI/ MRA of head and neck and Echocardiogram | * if PHACE is suspected: MRI/ MRA of head and neck and Echocardiogram | ||
| * Slow titration up, lowest effective dosing, inpatient observation and TID dosing | * Slow titration up, lowest effective dosing, inpatient observation and TID dosing | ||
| + | === Protocol === | ||
| + | [[propranolol_for_hemangioma_protocol|See Outpatient Treatment of hemangioma with Propranolol Protocol]] | ||
| + | |||
| + | === Treatment Location === | ||
| + | * Inpatient for <8 weeks old or any age with inadequate social support or co-morbid conditions affecting the cardiovascular or respiratory system | ||
| + | * Outpatient for > 8 weeks old with good social support and no co-morbid conditions | ||
| + | |||
| ==== Adverse Effects ==== | ==== Adverse Effects ==== | ||
| Line 57: | Line 73: | ||
| =====Other Treatments===== | =====Other Treatments===== | ||
| + | * Surgical Excision | ||
| - | |||
| - | * Surgical Excision | ||
| ===== References ===== | ===== References ===== | ||
| - | * A Randomized, Controlled Trial of Oral Propranolol in Infantile Hemangioma {{: | + | |
| - | * Initiation and Use of Propranolol for Infantile Hemangioma: Report of a Consensus Conference {{http:// | + | |
| + | * Initiation and Use of Propranolol for Infantile Hemangioma: Report of a Consensus Conference | ||
| {{tag> | {{tag> | ||