Propranolol Dosing Guidelines

Infantile Hemangiomas

• The British Journal of Dermatology recommends a starting dose of 1 mg/kg daily in three divided doses for infantile hemangiomas 1
• For preterm infants or those with comorbidities, a lower starting dose of 0.5 mg/kg daily is recommended 1, 2
• The maximum dose for non-responders is 3 mg/kg daily 2

Special Considerations and Monitoring

• The British Journal of Dermatology suggests that for patients with comorbidities, preterm infants, or those with low weight, more cautious dosing schedules are needed 1, 2
• Propranolol is contraindicated in patients with asthma, obstructive airway disease, decompensated heart failure, second or third-degree heart block, and history of hypoglycemic episodes 3

Anxiety Treatment

• Lower doses are typically used for anxiety compared to cardiovascular indications, with baseline assessment of heart rate and blood pressure recommended before starting treatment 3
• Monitoring for hypotension and bradycardia is advised, especially at higher doses 3