Oral Ibuprofen versus Intravenous Indomethacin for Closure of Patent Ductus Arteriosus in Very Low Birth Weight Infants

Lee, Cheng‐Han; Chen, Hsiao-Neng; Tsao, Long-Yen; Hsiao, Chien‐Chou; Lee, Meng-Luen

doi:10.1016/j.pedneo.2012.08.011

Cited by 16 publications

(25 citation statements)

References 26 publications

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“…12 The overall rate of ductal closure is similar in infants treated with intravenous indomethacin and oral ibuprofen. [17][18][19] Intravenous indomethacin is associated with higher side effects than oral ibuprofen. 18,19 Intravenous ibuprofen is associated with approximately 30% greater risk of chronic lung disease than intravenous indomethacin.…”

Section: ■ Discussionmentioning

confidence: 99%

“…[17][18][19] Intravenous indomethacin is associated with higher side effects than oral ibuprofen. 18,19 Intravenous ibuprofen is associated with approximately 30% greater risk of chronic lung disease than intravenous indomethacin. 9 Oral ibuprofen appears to be as effective as intravenous ibuprofen and intravenous indomethacin for closing the patent ductus arteriosus.…”

Section: ■ Discussionmentioning

confidence: 99%

“…24 Oral ibuprofen is associated with significantly fewer cases of necrotizing enterocolitis and has significantly lower creatinine levels than intravenous indomethacin. 19 Oral ibuprofen reduces the risk of necrotizing enterocolitis and transient renal insufficiency and this drug appears to be the drug of choice for closing the patent ductus arteriosus in preterm infants. 23 The continuous slow intravenous administration of indomethacin does not affect the serum concentration of creatinine and the renal, intestinal and cerebral blood flow velocities.…”

Section: ■ Discussionmentioning

confidence: 99%

“…14 The overall rate of ductal closure was 88.5% indomethacin and 81.8% with ibuprofen. Lee et al 19 compared the effects and complications of ductus arteriosus closure intravenous indomethacin (n = 85) vs oral ibuprofen (n = 52) in neonates weighing < 1500 grams. The closure rate was similar, but oral ibuprofen was associated with significantly fewer cases of necrotizing enterocolitis and had significantly lower rates of elevated creatinine levels.…”

Section: Intravenous Indomethacin Vs Oral Ibuprofenmentioning

confidence: 99%

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Ibuprofen and indomethacin for the closure of the patent ductus arteriosus

Pacifici¹

2016

Medical Express

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The ductus arteriosus connects the pulmonary artery with the aorta and allows right ventricular blood to bypass the unexpanded lungs. In mature infants, the ductus arteriosus closes after birth. Patent ductus arteriosus occurs in 70% of preterm infants with a birth weight < 1,000 grams. Failure of the ductus arteriosus to close has been associated with intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, periventricular leukomalacia, renal failure, and persistent pulmonary hypertension. The drugs used to treat the patent ductus arteriosus are ibuprofen and indomethacin which are potent non-selective inhibitors of cyclo-oxygenase (COX) and therefore inhibit prostaglandin E2 synthesis. Prostaglandin E2 relaxes smooth muscle and tends to inhibit the closure of the patent ductus arteriosus. Intravenous ibuprofen and indomethacin inhibit prostaglandin E2 synthesis and thereby close the patent ductus arteriosus with similar efficacy. Indomethacin reduces the blood flow velocity in kidneys, intestine and brain. Ibuprofen has less effect on blood flow velocity in these organs. There is a significant increase in serum creatinine after indomethacin administration but not after ibuprofen and infants treated with ibuprofen have higher creatinine clearance. Oliguria (urine output < 1 ml/kg/h) occurs more frequently with indomethacin than with ibuprofen. Indomethacin requires furosemide for urine output more often than ibuprofen. Ibuprofen reduces the risk of necrotizing enterocolitis and transient renal insufficiency and it is the drug of choice for closing the patent ductus arteriosus. Ibuprofen and indomethacin may be administered orally. In conclusion, intravenous ibuprofen and indomethacin close the patent ductus arteriosus at the same rate, but indomethacin is more toxic than ibuprofen.

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Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Discussionmentioning

confidence: 99%

Section: Intravenous Indomethacin Vs Oral Ibuprofenmentioning

confidence: 99%

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Ibuprofen and indomethacin for the closure of the patent ductus arteriosus

Pacifici¹

2016

Medical Express

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“…Age-related diseases such as arthritis and osteoporosis cause women to take analgesics and nonsteroidal antiinflammatory drugs (NSAIDs) more often (Lapane et al 2001). Whereas NSAIDs, namely ibuprofen and indomethacin (INDO) are the common cause of worsening in blood pressure (Sarafidis and Bakris 2008); especially INDO is used for the contractile treatment of patent ductus arteriosus (Lee et al 2012), another NSAID low-dose aspirin (ASP) is used as a longterm major treatment for prevention of cardiovascular disease. Most of the effects of ASP are attributed to its antithrombotic activity which is exerted by inhibition of cyclooxygenase-1 (Taubert et al 2004;Tauseef et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Antioxidative effect of aspirin on vascular function of aged ovariectomized rats

Demirci

Demir

Dost

et al. 2013

AGE

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This study investigated the vascular effects of nonsteroidal anti-inflammatory drugs (NSAIDs) in the very late stage of postmenopausal vascular aging and looked for a better choice of anti-inflammatory drug for women in reducing the cardiovascular risk by decreasing the oxidant status in this term. The rat aorta isolated from young and old rats that were treated with either aspirin (10 mg/kg/day) or indomethacin (INDO, 1 mg/kg/day) within last 10 weeks after 16-month overiectomy (OVX) follow-up. Endothelium-dependant acetylcholine (Ach, 0.001-30 μM) and independent sodium nitroprusside (SNP, 0.0001-3 μM) relaxant; α-receptor phenylephrine (PE, 0.001-30 μM) and voltage-dependant high potassium (KCl; 40 mM) contractile responses were assessed. Total oxidant and antioxidant status were measured from the serum samples. Aged OVX rat's both aortic endothelium and smooth muscle relaxation were significantly less than of younger ones, whereas their contractile functions tended to decrease. INDO did not treat the Ach, SNP responses, whereas it increased the PE and KCl contractility. Aspirin improved the relaxation function and antioxidant capacity and decreased the oxidant status. These data demonstrate that even if they are in the very late stage of life and menopause, the analgesic choices could restore the well established endothelial dysfunction, vascular stiffness, and oxidant status.

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Comparative study of the efficacy and safety of paracetamol, ibuprofen, and indomethacin in closure of patent ductus arteriosus in preterm neonates

et al. 2016

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Paracetamol is as effective as indomethacin and ibuprofen in closure of PDA in preterm neonates and has less side effects mainly on renal function, platelet count, and GIT bleeding. What is Known: • Hemodynamically significant patent ductus arteriosus has many complications for preterm and low birth weight neonates and better to be closed. Many drugs were used for medical closure of PDA e.g. indomethacin, ibuprofen and recently paracetamol. Many studies compare safety and efficacy of paracetamol with either indomethacin or ibuprofen. What is New: • It is the first large study that compares the efficacy and side effects of the three drugs in one study.

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Oral Ibuprofen versus Intravenous Indomethacin for Closure of Patent Ductus Arteriosus in Very Low Birth Weight Infants

Cited by 16 publications

References 26 publications

Ibuprofen and indomethacin for the closure of the patent ductus arteriosus

Ibuprofen and indomethacin for the closure of the patent ductus arteriosus

Antioxidative effect of aspirin on vascular function of aged ovariectomized rats

Comparative study of the efficacy and safety of paracetamol, ibuprofen, and indomethacin in closure of patent ductus arteriosus in preterm neonates

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