Neonatal Drug Therapy Manual

Propranolol

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated January 26, 2022 - 6:00pm

Alternate Name(s): 
Inderal
Classification: 
Beta-Blocker, Antiarrhythmic Agent class II
Original Date: 
June 1996
Revised Date: 
February 2021
Indications: 
  • Tachyarrhythmias and hypertension
  • Palliation of Tetralogy of Fallot
  • Neonatal thyrotoxicosis
Administration: 
  • IV direct: over 10 minutes
  • PO
Dosage: 
  • IV: 0.01 - 0.15 mg/kg/dose Q 6-8 H.  Titrate dose slowly
  • PO: 1 - 5 mg/kg/day divided Q 6-8 H
    • Thyrotoxicosis: 2 mg/kg/day divided Q 6-12 H
      • Available as a suspension and 10 mg tablet.  If unable to take suspension round dose to the nearest 1/4 tablet
Side Effects: 
  • CVS: bradycardia, hypotension, heartblock
  • Endrocrine and metabolic: hypoglycemia, hyperglycemia
  • Hematologic: agranulocytosis
  • Respiratory: bronchospasm
Parameters to Monitor: 
  • ECG- acutely
  • BP, HR
  • Serum electrolytes
  • Serum glucose: consider blood glucose monitoring q6h for the first 24 - 48 hours following initiation /dose titration.  Blood glucose ac feeds and/or 1-2 hours post-dose .
Compatibility: 

- Solutions Compatible: D5W, 0.9 % NaCl, dextrose-saline combinations

- Y-site Compatible: dobutamine, heparin, KCl, milrinone, morphine

References: 

- Taketomo CK,  Hodding JH, Kraus DM.  Pediatric & Neonatal Dosage Handbook 22nd Edition. Hudson: Lexi-Comp Inc.; 2015

- Trissel LA. Handbook on Injectable Drugs. 19th Editions. Bethesda: American Society of Health-System Pharmacists; 2017

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