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-   -   Proper dosage and use of propranolol while sick (http://birthmark.org/board/showthread.php?t=6509)

kg8183 09-23-2013 06:10 PM

Proper dosage and use of propranolol while sick
 
Hi guys,

Have been away from the forum for a little bit. I am here to give an update and also ask few questions.

Thankfully, the ulcerations on our son's hemangioma healed in about 5 weeks after 1 laser pulse dye therapy, dressing the wound 2 times a day with Mupirocin Calcium 2% cream and the continued use of propranolol. It was a very tough 5 weeks, but my wife, son and I hung in there. Thank you all for your support, we really appreciate it. The hemangioma has gotten significantly lighter in color and is not as swollen. However, for the last 3-4 weeks we have not seen progress. In fact, it seems that it is getting a little more red and, perhaps, a bit raised.

So here are my questions:
1) Currently, my son, who is just over 5 months of age, has cold and the typical symptoms associated with it (i.e. low fever in '99s, cough, congestion, runny noise, vomiting, reduced appetite). We saw the pediatrician today and she confirmed that he does not have ear infections and the lungs seem to be ok,too. We are little concerned about giving him propranolol while he is sick. What is your experience/knowledge regarding the matter?

2) My son continues to take 0.7 ml of propranolol 3 times a day. At the time of prescribing this dose, with his weight taken into consideration, it was effectively the regular 2 mg/3 time a day dose that seems to be common amount prescribed for the treatment. Today, our son's weight is 14 lbs 8.5 oz. If I adjust the dose per his weight to the 2mg per kg of body weight, he should be taking approximately 1.1 ml every 8 hours (3.3 ml in 24 hrs). In fact, the 0.7 ml 3 time a day translates into 1.27 ml per kg of body weight, which is significantly lower than the accepted norms. The specialist insists that we continue to give him 0.7 ml every 8 hrs. My personal opinion, for what it is worth, is that it is because of the low dose that he is taking that we don't see recent progress with the hemangioma treatment with propranolol. What experience/knowledge do you have with increasing dose as the child grew older?

THank you in advance

missy 09-23-2013 09:55 PM

Hi! Thank you so much for the update. However, you should really ask a physician. I would suggest Dr. Levitin here:

Http://birthmarks.org/experts.php

He can probably give you the best answer.

Hope your baby feels better soon. The whole family has already been through so much!

Missy

Crobbins 09-25-2013 02:18 AM

My Daughter was on propranolol starting at 12 weeks to a year. We had monthly and then bi-monthly visits to her cardiologist who would increase her dosage based on her weight gain (and towards the end.. the very beginning of the weaning process was to NOT increase the dosage as she got heavier) She had many colds/fevers during that year (she is the youngest of 4 .. 3 older siblings brought home EVERY germ from school) w/o any issue-- we were told that we should give it to her when she was sick except if she was throwing up and had NOTHING in her stomach for a long period of time.. that was when the low blood pressure issues surfaced (in the studies they had done, not with her personally) -- personally we never increased the dosage w/o the Cardiologists go ahead.. my husband works in Pharma and is a huge stickler regarding medication and the correct dosage.. :-D


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