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Clin Perinatol. 2012 Mar;39(1):111-36. doi: 10.1016/j.clp.2011.12.002. Epub 2012 Jan 13.

Evidence-based use of indomethacin and ibuprofen in the neonatal intensive care unit.

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  • 1Neonatal-Perinatal Medicine, Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232-9544, USA.


Indomethacin and ibuprofen are potent inhibitors of prostaglandin synthesis. Neonates have been exposed to these compounds for more than 3 decades. Indomethacin is commonly used to prevent intraventricular hemorrhage (IVH), and both drugs are prescribed for the treatment or prevention of patent ductus arteriosus (PDA). This review examines the basis for indomethacin and ibuprofen use in the neonatal intensive care population. Despite the call for restrained use of each drug, the most immature infants are likely to need pharmacologic approaches to reduce high-grade IVH, avoid the need for PDA ligation, and preserve the opportunity for an optimal outcome.

Copyright © 2012 Elsevier Inc. All rights reserved.

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