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Propranolol is FDA approved for treatment of infantile hemangioma (IH), when treatment is needed (see NEJM JW Dermatol Aug 2011). Sleep disturbances (restless sleep, night terrors) are a known side effect of propranolol. Nadolol, a hydrophilic nonselective beta-blocker, was safe and effective for treatment of IH in a small study.
These investigators describe nadolol treatment of seven infants from a larger study who discontinued propranolol due to sleep disturbance. The median age at initiation of propranolol therapy was 5 months (range, 2–44 months); mean duration of propranolol at discontinuation was 4.8 +/- 3 months; and the mean dose was 2 mg/kg/day. Seven of nine patients who developed sleep disturbance were switched to oral nadolol sol…