What is the role of indomethacin (Indocin) in the treatment of patent ductus arteriosus (PDA)?

Updated: Nov 20, 2018
  • Author: Luke K Kim, MD; Chief Editor: Stuart Berger, MD  more...
  • Print
Answer

Indomethacin has proven efficacious, resulting in twice the spontaneous closure rate. [10] McCarthy et al demonstrated the successful effects of indomethacin therapy on patent ductus arteriosus (PDA) in 4 newborns with a birth weight of 1500-2075 g who were born at a gestational age (GA) of 35 weeks or more. [11]

Watanabe et al evaluated indomethacin therapy in 13 infants with patent ductus arteriosus (PDA) complicated by congenital heart disease and reported closure in 4 of 7 infants with a birth weight of 2500 g or more. [12] Indomethacin was shown to be successful in both cases; however, the ductus may reopen days or weeks later. Prophylactic indomethacin was also found to reduce the incidence of severe grades of intracranial hemorrhage. Side effects of indomethacin include cerebral vasoconstriction. [12]

These drugs cause adverse renal effects, because renal perfusion and diuresis in early neonatal life are strongly influenced by the effects of prostaglandins on the afferent glomerular arterioles.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!