SERUM INDOMETHAC1N CONCENTRATIONS AFTER INTRAVENOUS ADMINISTRATION TO PRETERM INFANTS WITH PATENT DUCTUS ARTERIOSUS

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Abstract
Six preterm infants with PDA [patent ductus arteriosus] received 14 treatments with indomethacin 0.2 mg/kg i.v. Auscultatory and echocardiographic assessment indicated closure of the duct in 2, partial closure in 2 and no effect in 2 infants. The mean serum concentration of indomethacin was 15 min after the 1st injection 1314 ng/ml, after 1 h 970 ng/ml, after 6 h 718 ng/ml and after 24 h 388 ng/ml. The mean half-life of indomethacin in the serum was 20 h (range 9-50 h). Side effects in all infants were hyponatremia, decreased urinary output, decreased urinary Na excretion and weight gain. One infant had transient thrombocytopenia and gastrointestinal hemorrhage. By i.v. administration of indomethacin in a dose of 0.2 mg/kg to preterm infants a sufficiently high serum concentration is obtained shortly after the injection. To maintain a high serum concentration for a longer period it is recommended to give a 2nd dose of 0.2 mg/kg after 6 h and if necessary a 3rd dose of 0.1 mg/kg 24 h after the 1st dose.