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...
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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.

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