A study published in JAMA Pediatrics suggests that nadolol can be considered as a noninferior and probably an even better alternative to the standard propranolol for the treatment of infantile hemangioma (IH).

The double-blind, randomized noninferiority study, conducted from 2016 to 2020 in Ontario, Canada, included 71 infants with a corrected gestational age of 1 to 6 months with hemangiomas more than 1.5 cm on the face or 3 cm or greater on any other part of the body, with the potential to result in functional impairment or cosmetic damage.

Patients received either nadolol (oral suspension, 10 mg/mL) or propranolol (oral suspension, 5 mg/mL) starting at a dose of 0.5 mg/kg/day twice a day, titrated weekly by 0.5 mg/kg/day till a maximum dose of 2 mg/kg/day. The dose was then adjusted until week 24, based on patient’s weight and clinical response. Following this, the parents could choose to continue with the assigned treatment or switch to the other regimen. At week 24, the between-group differences of IH size and color were 8.8 and 17.1, respectively, favoring nadolol. The results were similar at week 52. The mean size involution compared with baseline was better (97.9%) in the nadolol group compared to the propranolol group (89.1%), as was mean color fading (94.5% in nadolol group vs. 80.5% in propranolol group)… (Medscape)