Exploring Nadolol as a Therapeutic Option for Infantile Hemangioma: A Narrative Review

Infantile hemangioma (IH) is a common vascular tumor of infancy, characterized by rapid early growth and gradual spontaneous involution. Propranolol remains first-line therapy for complicated IH but is limited by adverse effects and contraindications in some infants. Nadolol, a nonselective beta-adrenergic antagonist with a longer half-life and reduced CNS penetration, has been proposed as an alternative. Evidence suggests these pharmacokinetic properties may improve safety, reduce neurocognitive side effects, and enhance adherence while achieving comparable efficacy to propranolol. However, data are limited, particularly regarding long-term safety and standardized dosing protocols. Further controlled studies are needed to define nadolol's role in IH management.