Generic Name: Indomethacin
Product Name: Indocid PDA
Patent ductus arteriosus (PDA) in premature infants when usual medical management (eg. fluid restriction, diuretics, digitalis, respiratory support) is ineffective.The drug should only be used in a hospital under supervision.
Exact mechanism of action is not known, but it is believed to be a potent inhibitor of prostaglandin synthesis.In human newborns with certain congenital heart malformations, PGE2 dilates ductus arteriosus.
Dosage depends on the age of the infant at time of therapy.Therapy is defined as three intravenous doses of Indocid PDA given at 12 to 24 hour intervals, with careful attention to urinary output.
- If age is < 48 hours: first dose is 0.2 mg/kg, second dose is 0.1 mg/kg and third dose is 0.1 mg/kg.
- If age is 2 to 7 days: first dose is 0.2 mg/kg, second dose is 0.2 mg/kg and third dose is 0.2 mg/kg.
- If age is > 7 days: first dose is 0.2 mg/kg, second dose is 0.25 mg/kg and third dose is 0.25 mg/kg.
Studies have found that indomethacin has a greater effect in reducing mortality and bronchopulmonary dyaplasia when given at two to three days rather than seven to ten days.
- Solution should be prepared only with 1 to 2 ml of preservative free sterile sodium chloride injection 0.9% or preservative free sterile water for injection. All diluents should be preservative free.
- If 1ml of diluent is used, concentration of indomethacin in solution will equal 0.1mg/0.1ml.
- If 2ml of diluent is used, concentration of indomethacin in solution will equal 0.05mg/0.1ml.
- Once reconstituted, indomethacin solution may be injected intravenously over five to ten seconds.
Common side effects
- Bleeding problems: gross or microscopic bleeding into gastrointestinal tract, pulmonary haemorrhage, disseminated intravascular coagulation and oozing from skin after needle puncture.
- Renal dysfunction: reduced urinary output; reduced urine sodium, chloride or potassium, urine osmolality, free water clearance or glomerular filtration rate; elevated serum creatinine.
- Metabolic: hyponatremia, elevated serum potassium, hypoglycaemia.
- Coagulation: decreased platelet aggregation.
- Cardiovascular: pulmonary hypertension, intracranial bleeding.
For further information talk to your doctor.