{"id":8800,"date":"2026-08-11T08:27:20","date_gmt":"2026-08-11T08:27:20","guid":{"rendered":"https:\/\/majistraleczacilari.org.tr\/?post_type=docs&p=2948"},"modified":"2026-08-21T12:34:40","modified_gmt":"2026-08-21T12:34:40","password":"","slug":"contribution-of-magistral-formulation-in-the-treatment-of-infantile-hemangioma","status":"publish","type":"docs","link":"https:\/\/majistraleczacilari.org.tr\/en\/dokumanlar\/syrups\/contribution-of-magistral-formulation-in-the-treatment-of-infantile-hemangioma\/","title":{"rendered":"Contribution of magistral formulation in the treatment of infantile hemangioma"},"content":{"rendered":"
<\/div>\n
\n

\"\"Infantile hemangiomas are the most common tumors of infancy, and most resolve over time without requiring any treatment. Being a congenital condition, vascular birthmarks (hemangiomas) are therefore frequently seen in infants. The primary concern with vascular birthmarks is usually cosmetic appearance. Those in the facial and lip regions, in particular, can appear quite dramatic. The second major issue is surface damage leading to bleeding. Bleeding episodes can reach fatal levels. They occur 6 times more frequently in females than in males. They are rare in individuals of Black descent. They are most commonly observed on the head, neck, face, arms, and legs. Hemangiomas are most prevalent in children of Caucasian descent. Between 4% and 10% of Caucasian infants develop this benign tumor. In addition, they are more common in girls, especially those with fair skin. Individuals with a family history of hemangioma or those who have had this condition previously have an increased risk of developing hemangiomas. Hemangiomas may not be noticeable in the first 2 weeks of life. They can appear red, dark red, red in the center with a cream-colored border, ulcerated and inflamed, and may be situated deep or on the skin surface. These varying appearances of hemangiomas depend on multiple factors. Hemangiomas can present in different colors and forms at various stages of the condition. Because hemangioma types in infants vary, the appropriate treatment may also differ.\"\"Only 1% of hemangiomas are fatal. Severe lesions that can cause respiratory distress and visual impairment by settling in the airway and orbit, as well as lesions that have the potential to lead to both cosmetic problems and complications such as ulceration, bleeding, and infection by settling in areas like the face, ear, and nose, may require treatment. Danger arises if a hemangioma develops in an internal organ.<\/p>\n

Hemangioma may present in the following forms;<\/p>\n

-Port-wine stain; like a superficial mark<\/p>\n

-Strawberry (cherry-strawberry); small vascular marks<\/p>\n

-Large vascular mark (cavernous hemangioma) very large<\/p>\n

Hemangioma treatment is performed using the following methods;<\/p>\n

-Surgical excision<\/p>\n

-Freezing treatment (cryotherapy)<\/p>\n

-Cauterization by heating (cautery or infrared coagulation)<\/p>\n

-Foam sclerotherapy<\/p>\n

-Light therapy (laser)<\/p>\n

-Medical treatment\"\"In the medical treatment of hemangioma lesions, steroids, interferon, and vincristine have long been used. In 2008, L\u00e9aut\u00e9-Labr\u00e8ze et al. first initiated propranolol treatment in a 9-week-old infant who had hemangiomas on the face and eyelid and was receiving steroid therapy for four weeks, after the development of heart failure. Seven days later, a significant reduction in the size of the hemangioma was observed. Sans et al. used propranolol in 32 patients with hemangioma. In one patient, treatment was discontinued due to respiratory system-related side effects of propranolol, while in the other 31 patients, significant changes in the color and size of the hemangioma were observed with propranolol therapy. Jephson et al. also used propranolol in patients with 9 cutaneous hemangiomas and 2 subglottic hemangiomas and achieved success. Propranolol is a drug that can cause various complications, especially in infants younger than 6 months; therefore, in many clinics, patients treated with propranolol are closely monitored with various follow-up protocols. Infantile hemangiomas (IH) are the most common childhood tumors. They occur in approximately 1-2% of newborns and are more frequent in premature infants. They complete their course in 3 stages. In the first few weeks of life, they enter a proliferative phase that is completed within 4-6 months; in deep or large segmental IHs, this phase can last up to 1 year. This is followed by a plateau phase where growth ceases. Subsequently, the involution phase begins, during which the lesion starts to regress. The involution phase is slower than the proliferative phase and is completed at age 4 in 60% of patients and at age 7 in 76% of patients. While most IHs resolve without leaving any sequelae, they may sometimes persist as atrophy, anetoderma, or a fibrofatty mass. Although early intervention is often necessary for severe lesions located in the airway and orbit that could lead to respiratory distress and visual impairment, lesions located predominantly in the head and neck region\u2014especially on the face, ears, and nose\u2014may also require treatment due to their potential to cause cosmetic issues as well as complications such as ulceration, bleeding, and infection. In the medical management of infantile hemangioma, steroids, interferon, and vincristine are agents that have been used traditionally. However, their use is limited due to numerous serious toxic side effects. Systemic corticosteroids are generally the first-choice agents in medical therapy. Although their success rate ranges between 78-89%, a high recurrence rate of 36% and severe side effects restrict their use.<\/p>\n

In conclusion, propranolol, a non-selective beta-blocker, was first used in 2008 by L\u00e9aut\u00e9-Labr\u00e8ze in a patient with obstructive cardiomyopathy; after the incidental finding of regression in the patient’s nasal hemangioma, numerous subsequent studies have indicated that it can be safely used even in infants younger than 6 months. However, propranolol can cause serious side effects such as bronchoconstriction, bradycardia, hypotension, hypoglycemia, decreased cardiac performance, and early cardiac failure. For this reason, patients must be closely monitored both before and during drug administration in accordance with a monitoring protocol. Patients with IH, once indicated, should receive oral propranolol treatment in collaboration with the pediatric cardiology and radiology departments.Formula;<\/strong><\/p>\n

Rp.<\/strong><\/p>\n

Propranolol       0.20 g<\/strong><\/p>\n

Citric acid          0.05 g<\/strong><\/p>\n

Simple syrup         50 ml<\/strong><\/p>\n

Distilled water     ad    100 ml<\/strong><\/p>\n

Ingredients in the formula;<\/strong><\/p>\n

Propranololo- Propranololum;<\/strong>Propranolol is the prototype of beta-adrenergic receptor antagonist drugs. It is a competitive, non-selective beta-blocker that does not exhibit intrinsic sympathomimetic activity (ISA). Although it has a membrane-stabilizing effect on the action potential, this effect has no clinical significance except in cases of overdose. Propranolol is actually a racemic compound, and only the l-isomer exhibits adrenergic blocking activity. An intranasal dosage form is being investigated for use in the treatment of migraine pain. It is used in the treatment of infantile hemangioma due to its effect on vascular endothelial growth factor.Citric acid- Acide citrique- Acidum citricum- Citronensaure;<\/strong>Citric acid and sodium citrate are orally administered alkalinizing medications. Preparations containing citric acid are used for dissolving kidney stones, alkalinizing urine, and preventing the obstruction of urinary catheters. Citric acid is a component of citrated anticoagulant solutions; it is also included in preparations used for the treatment of gastrointestinal disorders and metabolic acidosis. On the other hand, due to its mild astringent effect, citric acid helps alleviate the irritating effect of expectorants. Furthermore, solutions containing citric acid at a ratio of 1:500 are used as mouth and foot disinfectants. Citric acid is also used as an excipient in pharmaceutical technology for the preparation of effervescent granules, solutions, and syrups.<\/p>\n

After preparation, the product must be stored in the refrigerator protected from light. Its storage period is 30 days, and it should be shaken before use.<\/p>\n

Wishing you a good week\u2026<\/p>\n

References;<\/p>\n

1- Assoc. Prof. Dr. Mesut Ar\u0131c\u0131, Ege University Faculty of Pharmacy, Department of Pharmaceutical Technology.<\/p>\n

2- The Use of Propranolol in Subglottic Hemangioma Dr. Sevgi PEKCAN, a Dr. Yavuz K\u00d6KSAL, a Dr. Fatih ALTINTEPE, a Dr. Ey\u00fcp ASLAN, a Dr. Bahar G\u00d6KT\u00dcRK, a Dr. Mehmet Emin SAKARYA, b Dr. Kemal \u00d6DEVb a Department of Pediatrics, b Department of Radiology, Sel\u00e7uk University Meram Faculty of Medicine, Konya Date Received: 24.03.2010<\/p>\n

3- Use of propranolol as first-line treatment in infantile hemangioma: Case presentation The use of propranolol as first-line treatment of infantile hemangioma: Case presentation \u0130rfan Karaca1 , Erdal T\u00fcrk1 , Timur Me\u015fe2 , Beng\u00fc Demira\u011f3 , \u015eebnem Faytoncu4 1 \u0130zmir University Faculty of Medicine, Medical Park Hospital, Department of Pediatric Surgery, \u0130zmir 2 Dr. Beh\u00e7et Uz Pediatric Diseases and Surgery Training and Research Hospital, Pediatric Cardiology Clinic, \u0130zmir 3 Dr. Beh\u00e7et Uz Pediatric Diseases and Surgery Training and Research Hospital, Pediatric Oncology Clinic, \u0130zmir 4 Private Ege Health Hospital, Pediatric Cardiology Department, \u0130zmir<\/p>\n

Exp. Pharm. Ahmet Nezihi Pekcan
\nPekcan Pharmacy – Konya
\npekcanecz@gmail.com
\nTel: (332) 3520657http:\/\/www.majistralformul.com\/<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Infantile hemangiomas are the most common tumors of infancy, and most resolve over time without requiring any treatment. Being a congenital condition, vascular birthmarks (hemangiomas) are therefore frequently seen in […]<\/p>\n","protected":false},"author":1,"featured_media":2949,"comment_status":"open","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"doc_category":[165],"doc_tag":[],"class_list":["post-8800","docs","type-docs","status-publish","has-post-thumbnail","hentry","doc_category-syrups"],"acf":[],"year_month":"2026-09","word_count":1322,"total_views":"2","reactions":{"happy":"0","normal":"0","sad":"0"},"author_info":{"name":"m921a","author_nicename":"m921a","author_url":"https:\/\/majistraleczacilari.org.tr\/en\/author\/m921a\/"},"doc_category_info":[{"term_name":"Syrups","term_url":"https:\/\/majistraleczacilari.org.tr\/en\/dokuman-kategori\/syrups\/"}],"doc_tag_info":[],"knowledge_base_info":[],"knowledge_base_slug":[],"_links":{"self":[{"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/docs\/8800","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/docs"}],"about":[{"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/types\/docs"}],"author":[{"embeddable":true,"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/comments?post=8800"}],"version-history":[{"count":1,"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/docs\/8800\/revisions"}],"predecessor-version":[{"id":8802,"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/docs\/8800\/revisions\/8802"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/media\/2949"}],"wp:attachment":[{"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/media?parent=8800"}],"wp:term":[{"taxonomy":"doc_category","embeddable":true,"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/doc_category?post=8800"},{"taxonomy":"doc_tag","embeddable":true,"href":"https:\/\/majistraleczacilari.org.tr\/en\/wp-json\/wp\/v2\/doc_tag?post=8800"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}