From the Journals

Infantile hemangiomas: Calculating dose for propranolol is tricky


 

FROM THE JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

Use of Hemangeol was associated with fewer dosing errors than use of generic propranolol hydrochloride oral solutions in treating infantile hemangiomas, according to an online questionnaire survey.

Anastasia O. Kurta, DO, of Saint Louis University and her associates emailed a questionnaire to 531 physicians who were members of the Society for Pediatric Dermatology and physicians known to treat infantile hemangiomas. Most of the 220 physicians who responded were pediatric dermatologists. Of those, 90% had prescribed generic propranolol available in concentrations of 4 mg/mL and 8 mg/mL, and 58.6% had prescribed Hemangeol, the Food and Drug Administration-approved formulation of propranolol hydrochloride available in a concentration of 4.28 mg/mL.

Hemangiomas usually appear as rubbery collections of blood cells after birth. Wikimedia Commons/Zeimusu/Public Domain

Hemangiomas usually appear as rubbery collections of blood cells after birth.

Among the prescribers of generic propranolol, 30% said they or an assistant made one or more dose calculation errors. Of those who prescribed Hemangeol, 11% reported similar errors.

“A dosing chart accompanies propranolol 4.28 mg/mL [Hemangeol] using mL/kg doses, which eliminates conversion from milligrams to milliliters and could potentially explain the lower reported dose calculation error reported with propranolol 4.28 mg/mL,” Dr. Kurta and her associates said. “The risk of dispensing errors is increased for medications that are commercially available in different concentrations. Liquid medications prescribed for pediatric patients require additional computation for weight-based dosing and conversion, increasing the possibility of miscalculation.”

Daisy Dai, PhD, is employed by Pierre Fabre Pharmaceuticals and Elaine C. Siegfried, PhD, is a consultant for the company. Dr. Kurta and Eric S. Ambrecht, PhD, have no relevant financial disclosures.

Read more at J Am Acad Dermatol. 2017 May;76(5):999-1000.

Dr. Kurta reported no relevant financial disclosures.

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