THE POTENTIAL LONG-TERM SIDE-EFFECTS OF PROPRANOLOLE IN CHILDREN
Arturo Tozzi, MD, PhD
ASL Napoli 2 Nord, Naples, Italy
University of North Texas, Dept. of Physics, Center for nonlinear Science, Denton, Texas
Cite as: Tozzi A. Oral Propranolol for Infantile Hemangioma. N Engl J Med 2015; 373:284-285July 16, 2015DOI: 10.1056/NEJMc1503811
The paper by Léauté-Labrèze et al. emphasizes the therapeutic efficacy and the short-term safety of propranolole in the treatment of infantile hemangiomas. However, recent studies raise concerns regarding the potentially relevant long-term neurodevelopmental or cognitive side-effects of the highly lipophilic propranolol (1). Indeed, lipophilic beta-blockers cross the blood–brain barrier, leading to sleep and memory disturbance (2). To give some examples, sleep disturbance, somnolence and irritability have been observed in a significant number of infants treated with the propranolol (3), while it has been shown that such a drug decreases specific memory functions in adults (4). A recent review suggests that it appears conceivable that blockage of neural pathways critical for learning and memory could be an unrecognized long-term side-effect of propranolol in infants (5).
Further long-term studies are thus needed before to routinely suggest the use of the propranolol in the treatment of infantile hemangiomas.
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5 Hoeger PH. Propranolol for Infantile Haemangiomas: Certain Chances, Potential Risks. The British Journal of Dermatology. 2015;172(1):3-4.