Propranolol Discontinuation Guidelines

Infantile Hemangiomas

The British Society for Paediatric Dermatology recommends that propranolol can be stopped abruptly in patients with infantile hemangiomas, without the need for gradual tapering 1, 2
Treatment for infantile hemangiomas typically stops at 1 year of age, with most patients not requiring treatment beyond 17 months 1
Rebound growth of the hemangioma may occur in 10-25% of patients, but this is unrelated to tapering versus abrupt cessation 3, 4
The risk of rebound is highest when discontinuing before 12 months of age, with the lowest risk between 12-15 months 3, 4
Risk factors for rebound include mixed or deep morphology and female sex, not the method of discontinuation 3, 4

The British Society for Paediatric Dermatology is not applicable for cardiovascular indications, however, for patients with cardiovascular indications, such as angina or post-MI, propranolol must be tapered gradually over at least a few weeks to prevent potentially life-threatening rebound phenomena, as stated in the context of the article 1, 2