Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Hemangiol (Propranolol). If you are concerned about side effects, discuss the risks and benefits of Hemangiol (Propranolol) with your doctor.

The following side effects have been reported by at least 1% of people taking Hemangiol (Propranolol). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• agitation or irritability
• cold hands and feet
• Constipation
• decreased appetite
• Diarrhea
• drowsiness
• hair loss
• nightmares
• skin redness
• sleep problems
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blood circulation problems (e.g., cold, bluish, or numb fingers or toes)
• hallucinations (hearing or seeing things that aren't there)
• inflammation of the lungs (e.g., cough, wheeze, Fever, shortness of breath, trouble feeding, grunting, blue tinge to skin)
• low blood pressure (e.g., bluish skin, pale skin, fatigue, coldness)
• purple or reddish-brown spots visible under the skin
• signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• symptoms of low blood sugar (e.g., sweating, paleness, tiredness, irritability, fast heartbeat, poor feeding, hunger, nightmares)
• symptoms of too much potassium in the body (e.g., muscle fatigue, weakness, difficulty moving, abnormal heart rhythms, nausea)
• symptoms of psoriasis (e.g., pinpoint-sized red spots on skin, red, scaling, or crusted skin)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• abnormally low heart rate (e.g., fainting, paleness or bluish coloured skin, tiredness)
• serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• breathing problems (e.g., asthma, cough, fast or difficult breathing, wheezing, blue skin, shortness of breath)
• severe low blood sugar (e.g., decrease in body temperature, seizures, loss of consciousness, coma)
• symptoms of Raynaud's phenomenon (e.g., pale, painful, numb or cold fingers, toes, nose or earlobes)
• symptoms of slow or irregular heart rate (e.g., fainting, fatigue, coldness, paleness or bluish-coloured skin)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Hemangiol (Propranolol).

Each 1 mL of clear, colourless-to-pale-yellow, sugar-free, strawberry-vanilla-flavoured solution contains 4.28 mg of Hemangiol (Propranolol) hydrochloride, equivalent to 3.75 mg of Hemangiol (Propranolol). Nonmedicinal ingredients: citric acid monohydrate, hydroxyethylcellulose, purified water, sodium saccharin, strawberry flavour, and vanilla flavour.

Do not give Hemangiol (Propranolol) if your child:

• is allergic to Hemangiol (Propranolol) or any ingredients of the medication
• is premature and has not reached 5 weeks of corrected age
• weighs less than 2.5 kg
• is breast-fed, if the mother is taking any medications that should not be taken with Hemangiol (Propranolol)
• is in cardiogenic shock
• is prone to low blood glucose
• has Low Blood Pressure
• has a severely slow heart rate
• has Asthma or airways that easily spasm and close
• has serious heart block (second- and third-degree AV block) or sick sinus syndrome
• has severe circulatory disorders
• has a form of chest pain known as Prinzmetal's Angina
• has uncontrolled heart failure
• has a tumor diagnosed as pheochromocytoma

There may be an interaction between Hemangiol (Propranolol) oral solution and any of the following:

• Abiraterone
• alcohol
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• anti-malarial medications (e.g., chloroquine, hydroxychloroquine, Primaquine)
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• asunaprevir
• Baclofen
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-2 agonists (e.g., formoterol, Indacaterol, salmeterol, terbutaline, vilanterol)
• other beta blockers (e.g., Atenolol, Carvedilol, Timolol)
• brimonidine
• Bromocriptine
• Bupropion
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• cannabis
• Celecoxib
• Cholestyramine
• Cinacalcet
• ciprofloxacin
• Cobicistat
• Colesevelam
• Colestipol
• conivaptan
• Deferasirox
• dexmethylphenidate
• Digoxin
• Dipyridamole
• Disopyramide
• Donepezil
• Dronedarone
• Duloxetine
• ergot alkaloids (e.g., Dihydroergotamine, ergonovine, ergotamine, methylergonovine)
• epinephrine
• Fentanyl
• Fingolimod
• Galantamine
• grass pollen allergen extract
• Guanfacine
• HIV protease inhibitors (e.g., darunavir, tipranavir)
• insulin
• Ivabradine
• Lacosamide
• Lanreotide
• Leflunomide
• levodopa
• lidocaine
• Methadone
• Methylphenidate
• Mexiletine
• Mirabegron
• Morphine
• Nabilone
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• Obinutuzumab
• Octreotide
• Pasireotide
• Pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pramipexole
• Propafenone
• protein kinase inhibitors (e.g., Bortezomib, Ceritinib, imatinib, Tofacitinib)
• quinidine
• quinine
• Rasagiline
• rifampin
• Riociguat
• Rivastigmine
• Rizatriptan
• Ropinirole
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline)
• Selegiline
• sulfonylureas (e.g., Gliclazide, Glyburide, Tolbutamide)
• terbinafine
• Teriflunomide
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• tipranavir
• Tizanidine
• Tranylcypromine
• Zolmitriptan

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Hemangiol (Propranolol). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Hemangiol (Propranolol).

Breathing problems: In general, people who have asthma and certain other breathing problems or chronic lung disease should use Hemangiol (Propranolol) cautiously, as it can also have the effect of causing breathing difficulty. If your child develops a cold with shortness of breath and wheezing, treatment should be temporarily stopped. If your child has breathing problems, discuss with your doctor how Hemangiol (Propranolol) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Hemangiol (Propranolol), and whether any special monitoring is needed.

Heart conditions: Hemangiol (Propranolol) may cause symptoms of certain heart conditions to become worse. It may decrease the heart rate or blood pressure or may cause heart block. If your child has heart problems, discus with your child's doctor how Hemangiol (Propranolol) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Hemangiol (Propranolol), and whether any special monitoring is needed.

Kidney function: The safety and effectiveness of this using Hemangiol (Propranolol) have not been determined for children with kidney problems. Hemangiol (Propranolol) oral solution should not be used by children with decreased kidney function.

Liver function: The safety and effectiveness of this using Hemangiol (Propranolol) have not been determined for children with liver problems. Hemangiol (Propranolol) oral solution should not be used by children with decreased liver function.

Low blood sugar: Hemangiol (Propranolol) may cause low blood sugar or make low blood sugar worse in children. The early signs of low blood sugar, such as shakiness, hunger or rapid heartbeat, may not be as noticeable when taking Hemangiol (Propranolol). In children, unusual irritability, sleepiness, nightmares, or crying out during sleep may be signs of low blood sugar. Providing a sugary drink such as fruit juice can help relieve these symptoms. Talk to your doctor about the best way to treat these symptoms if they occur. Episodes of severe low blood sugar can cause seizures or be life-threatening.

It is recommended that Hemangiol (Propranolol) be given during or right after a feed to reduce the risk of low blood sugar developing.

Pheochromocytoma: Hemangiol (Propranolol) can worsen the symptoms of pheochromocytoma (a tumour of the adrenal gland) if it is taken alone. If your child has a pheochromocytoma, discuss with your doctor how Hemangiol (Propranolol) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Hemangiol (Propranolol), and whether any special monitoring is needed.

Severe allergies: People with allergies severe enough to cause Anaphylaxis (severe allergic reaction) (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe) should talk to their doctor about what to do if they have an allergic reaction. Hemangiol (Propranolol) may make it more difficult to treat their allergic reaction with Epinephrine.

Sleep and mood disturbances: People taking Hemangiol (Propranolol) may experience increased sleepiness, difficulty sleeping, or nightmares, as well as unusual irritability or anxiety. If you notice any behaviour in your child that seems unexpected or unusual, contact your doctor.

Surgery: Hemangiol (Propranolol) may interfere with other medications used for surgery and contribute to dangerously low blood pressure or rapid heartbeat. If your child is scheduled for surgery, inform all doctors involved in caring for your child that your child is taking Hemangiol (Propranolol).

Pregnancy: Hemangiol (Propranolol) is not intended to be used by women who are pregnant.

Breast-feeding: Hemangiol (Propranolol) oral solution is intended for infants and children and is not intended to be used by women who are breast-feeding. For breastfed babies, other medications that the mother takes may pass into breast milk and may interact with Hemangiol (Propranolol). Your doctor may change your medications to prevent these interactions.

Children: The safety and effectiveness of Hemangiol (Propranolol) has not been determined for children less than 5 weeks of age. It should not be given to premature children who have not reached the corrected age of 5 weeks.