Precautions for using timolol maleate eye drops for the treatment of hemangioma in infants and children

Instructions before use: Have an electrocardiogram (routine) or/and cardiac ultrasound (routine). Exclude arrhythmias, severe conduction block, congenital heart disease and other disorders. Contraindications: Timolol is contraindicated as a contraindication to cardiac pathology (conduction block) such as sinus tachycardia, atrioventricular block, heart failure, etc. Dosage: 3 times a day at 6-8 hour intervals (once in the morning, once in the afternoon and once in the evening), using thin medical cotton dipped in wet eye drops and applied to the surface of the tumor, keeping it moist for 10 min. Note to parents: Regular blood glucose monitoring is required, and blood glucose should be rechecked after 1 week of medication and every 1-2 months thereafter. During the treatment period, vaccinations can be received normally. In other special cases, follow-up is required at any time. Post-treatment response: 0.5% timolol maleate eye drops are effective from 3 days to 3 weeks after topical application, with an average onset time of 8 days and a treatment efficiency of 88.9%. Timolol maleate has a relatively fast onset of action and promotes a higher degree of lesion color fading. Since it is used topically, it has fewer adverse effects and can be used as the topical drug of choice for the treatment of superficial hemangioma in the proliferative phase. Duration of treatment: Drug therapy must be continued for at least 6 months, as premature discontinuation can lead to rebound. Discontinuation criteria: complete regression of hemangioma, or age over 1 year, end of proliferative phase of hemangioma. Taking medication strictly according to the doctor’s prescription and not reducing or stopping medication without authorization is crucial to avoid recurrence or rebound. Discontinuation method: The doctor will assess the discontinuation time according to the degree of tumor regression. Gradual discontinuation can be done by tapering the dosage or reducing the frequency of use. Safety: Studies have confirmed that topical use of timolol maleate eye drops is safe, effective and inexpensive for the treatment of infantile hemangiomas. The American Academy of Dermatologists and the American Academy of Pediatricians recommend it as one of the drugs of choice for the treatment of superficial limited infantile hemangiomas (small size). The following prospective, double-blind, controlled study of timolol maleate for the treatment of infantile hemangioma was published in the Journal of the American Academy of Pediatrics, the premier pediatric journal, as Level I evidence (the highest level of evidence) to guide clinical treatment.