Why is this medicine prescribed?
Propranolol oral solution is used to treat proliferating infantile hemangioma (noncancerous growths or tumors appearing on or under the skin shortly after birth) in infants. Propranolol is in a class of medications called beta blockers. It works by narrowing the blood vessels already formed and by preventing new ones from growing.
Are there other uses for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Propranolol comes as an oral solution (liquid) to take by mouth. Give twice daily (at least 9 hours apart) during or immediately after a meal. Give propranolol solution at around the same time(s) every day.
Give propranolol exactly as directed. Do not give your child more or less of it or take it more often than prescribed by the doctor.
Do not shake the oral solution container before use.
Follow the manufacturer's directions to measure the dose using the oral syringe supplied with the medication. You can give the solution to your child straight from the oral syringe. Or you can mix it with a small amount of milk or fruit juice and give it in a baby's bottle. Ask the pharmacist or doctor if you have any questions about how to use the oral syringe or give this medication.
If your child is unable to eat or is vomiting the dose, skip the dose and continue the regular dosing schedule when they are eating again.
Your doctor may start your child on a low dose of propranolol and increase the dose after a week, again at the end of the second week, and then as your child's weight changes afterward.
What special precautions should I follow?
Before you give propranolol oral solution,
- tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
- tell the doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products your child is taking or if you are a breastfeeding mother and are taking or plan to take any medications. A doctor may need to change the dose or monitor your child carefully for side effects. If you are breastfeeding, your doctor may tell you not to breastfeed during your child's treatment with propranolol.
- tell the doctor if your child was born prematurely, weighs less than 4.5 lbs (2 kg), or has a low blood pressure or pulse rate. Also, tell the doctor if your child has or has had asthma or other breathing problems, pheochromocytoma (a tumor on a small gland near the kidneys that causes high blood pressure), or heart failure. The doctor will probably tell you not to give propranolol oral solution.
- you should know that propranolol may increase the risk of hypoglycemia (low blood sugar) and prevent the warning signs and symptoms that would tell you that your child's blood sugar is low. Let your doctor know if your child is unable to eat or drink normally, is vomiting, or has a cold or other infection while they are receiving propranolol. You should know the symptoms of low blood sugar and what to do if your child has these symptoms. If your child experiences any of the following symptoms of hypoglycemia, call your doctor immediately or get emergency medical treatment: pale, blue or purple skin; sweating; irritability; crying more than usual; irregular or fast heartbeat; shallow or interrupted breathing; poor feeding; low body temperature; unusual sleepiness; seizures; or loss of consciousness.
- you should know that if your child has allergic reactions to different substances, the reactions may be worse while your child is taking propranolol and the allergic reactions may not respond to the usual doses of injectable epinephrine.
What special dietary instructions should I follow?
Unless the doctor tells you otherwise, the child should continue a normal diet.
What should I do if I forget to take a dose?
If you miss giving a dose, skip the dose and continue the regular dosing schedule. Do not give a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include:
- uncontrollable shaking of a part of the body
- slow or irregular heartbeat
- cough or wheezing
- dizziness, fainting
- seizures
What side effects can this medicine cause?
Propranolol may cause side effects. Tell your child's doctor if any of these symptoms are severe or do not go away:
- sleep problems
- vomiting
- diarrhea
- decreased appetite
Some side effects can be serious. If the child experiences any of the following symptoms or those in the SPECIAL PRECAUTIONS section, call the child's doctor immediately or get emergency medical treatment:
- difficulty breathing or swallowing
- wheezing
- shortness of breath
- sudden weakness of an arm or leg
- cold hands or feet, pale, blue or purple skin color, slow, irregular heartbeat, fainting
- unusual tiredness or fatigue
What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat, and moisture (not in the bathroom). Do not freeze. Dispose of any remaining propranolol oral solution 2 months after you first opened the bottle.
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information. Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.orgWhat other information should I know?
Keep all appointments with the doctor.
Do not let anyone else take this medication. Ask your pharmacist any questions you have about refilling the prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.