Serum ibuprofen levels of extremely preterm infants treated prophylactically with oral ibuprofen to prevent patent ductus arteriosus

Kanmaz, Gozde; Erdeve, Ömer; Canpolat, Fuat Emre; Oğuz, Şerife Suna; Uraş, Nurdan; Altuğ, Nahide; Greijdanus, Ben; Dilmen, Uğur

doi:10.1007/s00228-012-1438-8

Cited by 25 publications

(23 citation statements)

References 23 publications

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“…Indomethacin and ibuprofen are COX-inhibitor drugs commonly used for the treatment of hemodynamically significant (hs)-PDA. Despite the about 70% success rate, COX-inhibitors are frequently contraindicated in early life and their use has been associated with serious adverse events, such as gastrointestinal perforation, renal failure and bleeding [4-11]. Paracetamol, an inhibitor of the peroxidase component of PGHS, is commonly used in pediatric age, and has been recently proposed for the treatment of PDA [12-22].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of paracetamol for the treatment of patent ductus arteriosus in preterm neonates

et al. 2014

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Inhibitors of the cyclo-oxygenase component of prostaglandin-H2 synthetase, namely indomethacin and ibuprofen, are commonly used in the treatment of hemodynamically significant patent ductus arteriosus. These drugs are associated with serious adverse events, including gastrointestinal perforation, renal failure and bleeding. The role of paracetamol, an inhibitor of the peroxidase component of prostaglandin-H2 synthetase, has been proposed for the treatment of patent ductus arteriosus. We report a series of 8 neonates (birth weight: 724 ± 173 g; gestational age: 26 ± 2 weeks) treated with paracetamol for a hemodynamically significant patent ductus arteriosus, because of contraindications to ibuprofen or indomethacin. Successful closure was achieved in 6 out of 8 babies (75%). Median ductal diameter was significantly reduced after treatment (from 1.2 mm, range 1.0-2.5 mm to 0.6 mm, range 0.0-2.5 mm, p = 0.038). No adverse or side effects were observed during treatment. On the basis of these results, paracetamol could be considered a promising and safe therapy for the treatment of patent ductus arteriosus in neonates.

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Section: Introductionmentioning

confidence: 99%

Efficacy of paracetamol for the treatment of patent ductus arteriosus in preterm neonates

et al. 2014

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“…Incidence of acute renal failure reported in 4 studies (10) where Indomethacin group was 10.8% compared to 4.6% in Ibuprofen group, while Indomethacin group was 16.6% versus 14.2% in Ibuprofen group in study of (8) . Incidence of renal failure in the intervention group who were received Ibuprofen two infants developed acute renal failure (10%) in a study conducted by Kanmaz et al (11) , renal failure occurred in 1% as found by Olgun et al (12) .…”

Section: Discussionmentioning

confidence: 76%

“…One study compared standard dose to a high dose of Ibuprofen (15) .One examined the effect of repeated doses of oral Ibuprofen (12) . Two studies examined the effect of oral Ibuprofen (11,13) . Concerning the dose, all the infants receive either 3 doses of intravenous or oral Ibuprofen at an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 hours or three doses of IV Indomethacin 0.2 mg/kg at12-hour intervals, except in a study of Dani et al (15) where high-dose intravenous regimen (20-10-10mg/kg/day) was adminstred.…”

Section: Discussionmentioning

confidence: 99%

The Risk of Renal Injury in Infants Associated with Ibuprofen Use : A Systematic Review

Alkhattaf

Alqahtani²,

Alharbi³

et al. 2018

Egyptian Journal of Hospital Medicine

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Background: More recently ibuprofen, was used for the indication of the patency of ductus arteriosus closure in preterm infants; this drug is associated similar side effects include cerebral, renal, and mesenteric circulation. Methods: An electronic search was carried out using search terms such as "renal failure", "kidney failure", "renal injury", ibuprofen, "side effects", "adverse effect", complications. The search in MEDLINE and EMBASE through PubMed search engine resulted in 31 articles. These articles were screened for eligibility criteria included studies aimed to assess renal injury caused by ibuprofen use in infants. Results: After exclusion of irrelevant duplicated and review studies, 12 studies were included in this review. Eight studies were randomized control, 3 retrospective evaluation and 1 retrospective cohort study. the effect of the treatment on the renal function there are two outcomes reported either reduction in serum creatinine or incidence of acute renal failure. Incidence of acute renal failure reported in 4 studies. Conclusion: Although renal failure was more common in infants receiving Indomethacin compared to Ibuprofen, oral Ibuprofen was less toxic to the kidneys than intravenous and the serum creatinine levels after treatment did not differ, this is not significant.

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“…23 Ibuprofen levels, in relation to treatment response, were not significantly different in the case of success or failure of PDA closure. 57,58 Durrmeyer et al 59 observed that CYP2C polymorphism was not associated with PDA response to ibuprofen and this factor does not appear appropriate to optimize the ductal closure by modulating the ibuprofen dosing strategy. This suggests that ibuprofen concentration is not the only factor affecting the closing rate of PDA.…”

Section: ' Discussionmentioning

confidence: 99%

Clinical pharmacology of ibuprofen in preterm infants: A meta-analysis of published data

Pacifici

2014

Medical Express

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OBJECTIVES: Ibuprofen is a non-selective anti-inflammatory cyclooxygenase inhibitor drug of the propionic acid class of non-steroidal agents, available without prescription in the USA. In preterm infants, ibuprofen is used to close the Patent Ductus Arteriosus and it was found to be more effective than indomethacin. This metaanalysis determined whether differences exist in the closure rate of Patent Ductus Arteriosus following the oral vs. intravenous ibuprofen administration to preterm infants; it examines metabolism, pharmacokinetics and adverse renal effects of ibuprofen. METHOD: The bibliographic search was performed using PubMed and EMBASE databases as search engines. In addition, the books ''Neofax: a Manual of Drugs Used in the Neonatal Care'' by Young and Mangum and the ''Neonatal Formulary'' were consulted. RESULTS: Patent Ductus Arteriosus closure was 89% with oral ibuprofen (9 reports) vs. 75% with intravenous ibuprofen (13 reports); p = 0.011. The half-life (t 1/2) of ibuprofen is 43.1 and 26.8 hours in infants on the 3 rd and 5 th day of life, respectively. In adults, the half-life of ibuprofen is 2 hours. The rapid shortening of ibuprofen t 1/2 is due to the rapid increase of cytochromes CYP2C9 and CYP2C8 activities, which metabolize ibuprofen and which surge in the liver during the first weeks of life. Ibuprofen reduces the renal glomerular filtration and the sodium tubular transport rates. CONCLUSION: Oral ibuprofen is more effective than intravenous ibuprofen to close patent ductus arteriosus. Ibuprofen has fewer renal adverse effects than intravenous ibuprofen and has the most favourable risk/benefit ratio.

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Serum ibuprofen levels of extremely preterm infants treated prophylactically with oral ibuprofen to prevent patent ductus arteriosus

Cited by 25 publications

References 23 publications

Efficacy of paracetamol for the treatment of patent ductus arteriosus in preterm neonates

Efficacy of paracetamol for the treatment of patent ductus arteriosus in preterm neonates

The Risk of Renal Injury in Infants Associated with Ibuprofen Use : A Systematic Review

Clinical pharmacology of ibuprofen in preterm infants: A meta-analysis of published data

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