Which medications in the drug class Nonsteroidal Anti-inflammatory Agents (NSAIDs) are used 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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Answer

Nonsteroidal Anti-inflammatory Agents (NSAIDs)

In the neonate, ductal patency appears to be related to continued production of prostaglandin. This is particularly true in the premature infant; therefore, prostaglandin inhibition can affect ductal closure. NSAIDs inhibit the production of prostaglandins by decreasing the activity of cyclooxygenase. The result is a functional closure of the patent ductus arteriosus (PDA) in 80% of patients.

Ibuprofen lysine injection (NeoProfen)

The mechanism of action of ibuprofen lysine injection that results in patent ductus arteriosus (PDA) closure in neonates is not known; however, ibuprofen is an inhibitor of prostaglandin synthesis. This agent is indicated to close a clinically significant PDA in premature infants who weigh between 500-1500 g at ≤ 32 weeks' gestational age when the usual medical management (eg, fluid restriction, diuretics, respiratory support) is ineffective.

Indomethacin (Indocin)

Indomethacin is indicated for patent ductus arteriosus (PDA) closure, as it promotes closure of the PDA and generally has an onset of action within minutes. Prostaglandins, especially E-type prostaglandins, maintain the patency of the ductus. Thus, inhibition of prostaglandin synthesis by indomethacin results in constriction of the ductus arteriosus.


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