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Beta-Blocker — Infantile Haemangioma (Airway)

Propranolol

Brand names: Hemangiol, Inderal

Used in: Liver Disease & Cirrhosis Headache & Migraine

Propranolol is a non-selective beta-blocker used for migraine prophylaxis, anxiety with prominent somatic symptoms, essential tremor and the symptomatic control of thyrotoxicosis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION General Because of the variable bioavailability of propranolol, the dose should be individualized based on response. Hypertension The usual initial dosage is 40 mg propranolol hydrochloride twice daily, whether used alone or added to a diuretic. Dosage may be increased gradually until adequate blood pressure control is achieved. The usual maintenance dosage is 120 mg/day to 240 mg per day. In some instances a dosage of 640 mg a day may be required. The time needed for full antihypertensive response to a given dosage is variable and may range from a few days to several weeks. While twice-daily dosing is effective and can maintain a reduction in blood pressure …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-08-09. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It non-selectively blocks beta-1 and beta-2 adrenoceptors, reducing sympathetic drive to the heart and peripheral tissues.

Prescribing in practice

  • Avoid in asthma because of the risk of severe bronchospasm; use with caution in other obstructive airways disease.
  • Use with caution in heart failure, and be aware it can mask the warning signs of hypoglycaemia.
  • Do not stop abruptly, particularly in ischaemic heart disease, as rebound worsening can occur; withdraw gradually.

Monitoring

Monitor heart rate and blood pressure, and review for symptoms of bradycardia or heart failure. In diabetes, be alert to masked hypoglycaemia symptoms.

Counselling the patient

  • Do not stop taking it suddenly; your dose should be reduced gradually.
  • Tell your prescriber if you have asthma or wheezing, or if you develop breathlessness.
  • If you have diabetes, be aware it can hide some of the usual warning signs of a low blood sugar.

Evidence & guidelines

Guideline-recommended for migraine prophylaxis (NICE CG150).

Reference: Hemangiol SPC; Léauté-Labrèze et al. NEJM 2008; LEAP Trial; NICE guidance Infantile Haemangioma; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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