Hemangiol

The recommended dose of Hemangiol (Propranolol) oral solution is based on the child's body weight. The usual starting dose is calculated as 0.5 mg per kilogram of body weight, taken by mouth, 2 times a day. After 1 week, the doctor will increase the dose to 1 mg per kilogram of body weight, taken 2 times a day. After 1 week at this dose, the doctor will increase the dose to 1.5 mg per kilogram of body weight. Hemangiol (Propranolol) should be continued for 6 months and then stopped.

With the first dose and every time the dose is increased, the doctor may want you to wait for at least 2 hours, so the baby can be monitored to make sure heart rate and blood pressure remain normal and there are no severe reactions to the medication.

Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons. Do not shake the bottle before measuring the dose of medication.

Hemangiol (Propranolol) doses should be separated by at least 9 hours and given with feeds or immediately after the baby feeds to avoid low blood sugar levels. The medication may be mixed with 5 mL (for children weighing up to 5 kg) to 15 mL (for children weighing more than 5 kg) of milk or fruit juice in a baby bottle if necessary. This mixture should be used within 2 hours of preparation. To ensure the child gets the full dose of medication, do not put the dose in a full bottle.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to give Hemangiol (Propranolol) exactly as prescribed by your doctor. If your child vomits or spits up after a dose, do not give another dose. Continue with the next dose at the regular time.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Hemangiol (Propranolol) at room temperature, protect it from light and moisture, and keep it out of the reach of children. Hemangiol (Propranolol) should be discarded 60 days after opening the bottle.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause low blood sugar levels, which could make you feel dizzy, shaky or weak; it may lower your blood pressure, which could cause weakness and/or dizziness; it may cause diarrhea; it may decrease your appetite; it may cause unusual tiredness; it may cause nausea or, rarely, vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Each 1 mL of clear, colourless-to-pale-yellow, sugar-free, strawberry-vanilla-flavoured solution contains 4.28 mg of Hemangiol (Propranolol) hydrochloride, equivalent to 3.75 mg of Hemangiol (Propranolol). Nonmedicinal ingredients: citric acid monohydrate, hydroxyethylcellulose, purified water, sodium saccharin, strawberry flavour, and vanilla flavour.

Do not give Hemangiol (Propranolol) if your child:

• is allergic to Hemangiol (Propranolol) or any ingredients of the medication
• is premature and has not reached 5 weeks of corrected age
• weighs less than 2.5 kg
• is breast-fed, if the mother is taking any medications that should not be taken with Hemangiol (Propranolol)
• is in cardiogenic shock
• is prone to low blood glucose
• has Low Blood Pressure
• has a severely slow heart rate
• has Asthma or airways that easily spasm and close
• has serious heart block (second- and third-degree AV block) or sick sinus syndrome
• has severe circulatory disorders
• has a form of chest pain known as Prinzmetal's Angina
• has uncontrolled heart failure
• has a tumor diagnosed as pheochromocytoma

There may be an interaction between Hemangiol (Propranolol) oral solution and any of the following:

• Abiraterone
• alcohol
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• anti-malarial medications (e.g., chloroquine, hydroxychloroquine, Primaquine)
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• asunaprevir
• Baclofen
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-2 agonists (e.g., formoterol, Indacaterol, salmeterol, terbutaline, vilanterol)
• other beta blockers (e.g., Atenolol, Carvedilol, Timolol)
• brimonidine
• Bromocriptine
• Bupropion
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• cannabis
• Celecoxib
• Cholestyramine
• Cinacalcet
• ciprofloxacin
• Cobicistat
• Colesevelam
• Colestipol
• conivaptan
• Deferasirox
• dexmethylphenidate
• Digoxin
• Dipyridamole
• Disopyramide
• Donepezil
• Dronedarone
• Duloxetine
• ergot alkaloids (e.g., Dihydroergotamine, ergonovine, ergotamine, methylergonovine)
• epinephrine
• Fentanyl
• Fingolimod
• Galantamine
• grass pollen allergen extract
• Guanfacine
• HIV protease inhibitors (e.g., darunavir, tipranavir)
• insulin
• Ivabradine
• Lacosamide
• Lanreotide
• Leflunomide
• levodopa
• lidocaine
• Methadone
• Methylphenidate
• Mexiletine
• Mirabegron
• Morphine
• Nabilone
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• Obinutuzumab
• Octreotide
• Pasireotide
• Pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pramipexole
• Propafenone
• protein kinase inhibitors (e.g., Bortezomib, Ceritinib, imatinib, Tofacitinib)
• quinidine
• quinine
• Rasagiline
• rifampin
• Riociguat
• Rivastigmine
• Rizatriptan
• Ropinirole
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline)
• Selegiline
• sulfonylureas (e.g., Gliclazide, Glyburide, Tolbutamide)
• terbinafine
• Teriflunomide
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• tipranavir
• Tizanidine
• Tranylcypromine
• Zolmitriptan

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Hemangiol (Propranolol). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Hemangiol (Propranolol).

Breathing problems: In general, people who have asthma and certain other breathing problems or chronic lung disease should use Hemangiol (Propranolol) cautiously, as it can also have the effect of causing breathing difficulty. If your child develops a cold with shortness of breath and wheezing, treatment should be temporarily stopped. If your child has breathing problems, discuss with your doctor how Hemangiol (Propranolol) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Hemangiol (Propranolol), and whether any special monitoring is needed.

Heart conditions: Hemangiol (Propranolol) may cause symptoms of certain heart conditions to become worse. It may decrease the heart rate or blood pressure or may cause heart block. If your child has heart problems, discus with your child's doctor how Hemangiol (Propranolol) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Hemangiol (Propranolol), and whether any special monitoring is needed.

Kidney function: The safety and effectiveness of this using Hemangiol (Propranolol) have not been determined for children with kidney problems. Hemangiol (Propranolol) oral solution should not be used by children with decreased kidney function.

Liver function: The safety and effectiveness of this using Hemangiol (Propranolol) have not been determined for children with liver problems. Hemangiol (Propranolol) oral solution should not be used by children with decreased liver function.

Low blood sugar: Hemangiol (Propranolol) may cause low blood sugar or make low blood sugar worse in children. The early signs of low blood sugar, such as shakiness, hunger or rapid heartbeat, may not be as noticeable when taking Hemangiol (Propranolol). In children, unusual irritability, sleepiness, nightmares, or crying out during sleep may be signs of low blood sugar. Providing a sugary drink such as fruit juice can help relieve these symptoms. Talk to your doctor about the best way to treat these symptoms if they occur. Episodes of severe low blood sugar can cause seizures or be life-threatening.

It is recommended that Hemangiol (Propranolol) be given during or right after a feed to reduce the risk of low blood sugar developing.

Pheochromocytoma: Hemangiol (Propranolol) can worsen the symptoms of pheochromocytoma (a tumour of the adrenal gland) if it is taken alone. If your child has a pheochromocytoma, discuss with your doctor how Hemangiol (Propranolol) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Hemangiol (Propranolol), and whether any special monitoring is needed.

Severe allergies: People with allergies severe enough to cause Anaphylaxis (severe allergic reaction) (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe) should talk to their doctor about what to do if they have an allergic reaction. Hemangiol (Propranolol) may make it more difficult to treat their allergic reaction with Epinephrine.

Sleep and mood disturbances: People taking Hemangiol (Propranolol) may experience increased sleepiness, difficulty sleeping, or nightmares, as well as unusual irritability or anxiety. If you notice any behaviour in your child that seems unexpected or unusual, contact your doctor.

Surgery: Hemangiol (Propranolol) may interfere with other medications used for surgery and contribute to dangerously low blood pressure or rapid heartbeat. If your child is scheduled for surgery, inform all doctors involved in caring for your child that your child is taking Hemangiol (Propranolol).

Pregnancy: Hemangiol (Propranolol) is not intended to be used by women who are pregnant.

Breast-feeding: Hemangiol (Propranolol) oral solution is intended for infants and children and is not intended to be used by women who are breast-feeding. For breastfed babies, other medications that the mother takes may pass into breast milk and may interact with Hemangiol (Propranolol). Your doctor may change your medications to prevent these interactions.

Children: The safety and effectiveness of Hemangiol (Propranolol) has not been determined for children less than 5 weeks of age. It should not be given to premature children who have not reached the corrected age of 5 weeks.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. The two daily doses of this drug must be administered 9 hours apart. The second daily dose should be taken in the late afternoon. If a dose is spitted out in whole or in part, no additional dose should be administered and continue with the next scheduled dose. If you forget a dose, simply skip it and then take the next dose at the regularly scheduled time. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. It is preferable to take this medication with a meal or a snack in order to reduce adverse effects.