Propranolol therapy for hemangiomas in infants with neonatal abstinence syndrome may produce intolerable side effects

We report three infants with infantile hemangioma who experienced severe agitation and diarrhea following propranolol administration. Propranolol, a non‐selective β‐adrenergic receptor blocker, is the first‐line treatment for infantile hemangiomas. All three infants were exposed to opioids in utero...

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Bibliographic Details
Published in:Pediatric dermatology 2022-03, Vol.39 (2), p.273-274
Main Authors: Twist, Joanna, Chen, Anthony, Poffenberger, Paige, Zinn, Zachary
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - adverse effects
Adrenergic receptors
Babies
Beta blockers
Birthmarks
Central nervous system
Dermatology
Diarrhea
Drug abuse
Drug withdrawal
Hemangioma
Hemangioma - drug therapy
Hemangioma, Capillary - drug therapy
Humans
Iatrogenic Disease
Infant
Infant, Newborn
Infants
Intrauterine exposure
Neonatal abstinence syndrome
Neonatal Abstinence Syndrome - drug therapy
Neonatal Abstinence Syndrome - etiology
Neonates
Newborn babies
Opioid receptors
Pediatrics
Propranolol
Propranolol - adverse effects
Side effects
Skin Neoplasms - drug therapy
Treatment Outcome
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Summary:We report three infants with infantile hemangioma who experienced severe agitation and diarrhea following propranolol administration. Propranolol, a non‐selective β‐adrenergic receptor blocker, is the first‐line treatment for infantile hemangiomas. All three infants were exposed to opioids in utero and experienced neonatal abstinence syndrome at birth. We hypothesize that chronic opioid exposure in utero may cause protracted upregulation of β2‐adrenergic receptors in the central nervous system, resulting in increased susceptibility to adverse reactions to propranolol.
ISSN:0736-8046
1525-1470
DOI:10.1111/pde.14929