PDA treatment Ibuprofen versus Indocin

Specialties NICU

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We just started using Ibuprofen to treat our micropremie's PDAs. Is any NICU using this drug and do you have a protocol you could share with me? I have seen the huge problems using Indocin and hope this really will decrease the major side affects seen in using Indocin.

If we are unable to close the ductus we send for the "Duct Busters" fron CHOP. They arrive and in 45 minutes have completed the PDA ligation right at the bedside. The only changes in the unit are that no visitors are allowed in and all staff wear hats and masks while the surgery is done. So far none of our infants have gotten an infection.

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Specializes in NICU, PICU, educator.

I wish we would change over to ibuprofen....I hate indocin!

We do our ligations on the floor...we cleaned out one of our store rooms and now we use that. We used to do them in the room but our room have open windows between them and parents were getting upset that they couldn't come in and see/feed their kids as once the team arrived the room went into "lock down". Also, staff couldn't get in and out to do things, so that is how we ended up our own little room. Much nicer to do it on the floor...now if we could only get portable fluro on the floor for central lines LOL

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Specializes in PICU, ICU, Transplant, Trauma, Surgical.

Our unit uses Neoprofen (Ibuprofen) for PDA treatment. I'm sorry I don't know protocol or doses, I'm just tech there. We changed from Indocin to Neoprofen about 4 or 5 months ago I want to say.

Here is some info I found by googling "Neoprofen"

http://www.ovationpharma.com/images/products/pdf/neoprofen.pdf

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what is the side effect of indo ?

our unit use indo rare but for me I still didn't complete one years and during this periode I didnot see them use this...

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Specializes in NICU, CVICU.

I just took care of a baby that had a large PDA. Treated with Indocin x 3 doses, did not close. Treated with Neoprofen, closed some, but not completely. Became septic and the PDA opened up WIDE again (which came first, the chicken -PDA- or the egg -sepsis-?) with a very loud mumur. Had to have PDA ligation at 29 days old. Unfortunately, I didn't take care of him when he was on the neoprofen, so I don't know protocols, etc.

We do our PDA ligations at the bedside too...yep, 45 min-hour start to finish from when the OR team walks through the door until they are gone. The surgery only takes about 5 minutes though!

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Specializes in NICU.
what is the side effect of indo ?

our unit use indo rare but for me I still didn't complete one years and during this periode I didnot see them use this...

The two common side effects we see with Indocen are kidney failure and spontaneous bowel perforations.

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;) thank you gompers....
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Specializes in NICU.

We were involved in the double blind studies for indocin/ibuprofen. I was talking to our pharmacist and I guess ibuprofen has promise but is way more expensive than indocin.

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Specializes in Maternal - Child Health.
We were involved in the double blind studies for indocin/ibuprofen. I was talking to our pharmacist and I guess ibuprofen has promise but is way more expensive than indocin.

It is hard to believe that cost would be an issue with either drug, given that they are both available in generic form, and very widely used.

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Specializes in NICU, PICU, educator.

One would think Jolie, but there is one company that has the patent on the ibuprofen I believe, which used to be cheap, and they marked it up to about $800 per dose, whereas Indocin is much, much cheaper. Also, since it isn't a "golden" standard of care, insurance companies balk at paying and so does Medicaid, so the unit eats the cost. So, I think, until the price comes down, most places aren't changing their practice.

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