Ibuprofen lysine Brand Name– NeoProfen
What is Ibuprofen lysine
Ibuprofen lysine was developed for the treatment of patent ductus arteriosus (PDA) in premature infants.
It is an injectable l-lysine salt of ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) of the propionic acid chemical class. L-lysine is used to create a water-soluble solution suitable for intravenous administration.
In clinical studies, ibuprofen lysine has been shown to be as effective as intravenous indomethacin in closing PDA of premature infants with a success rate of approximately 75%.
Ibuprofen appears to be the drug of choice for closing a PDA due to its lower risk of necrotizing enterocolitis (NEC) and transient renal insufficiency compared to indomethacin.
Indomethacin is known to result in a marked decrease in blood flow to the cerebral, mesenteric, and renal circulation; echocardiographic study of animal models and preterm infants treated with ibuprofen lysine showed no significant reductions.
However, decreases in renal function in some ibuprofen lysine treated neonates were seen in subsequent studies.
Long term survival and effect on neurodevelopment have not been assessed.
Ibuprofen lysine was approved by the FDA in April 2006 to close clinically significant patent ductus arteriosus in infants weighing 500—1500 grams who are no more than 32 weeks gestational age when usual medical management is ineffective.
Indications
- patent ductus arteriosus (PDA)
For treatment of a clinically significant patent ductus arteriosus (PDA) in premature infants when usual medical management such as fluid restriction, diuretics, and respiratory support is ineffective
Side Effects
- anemia
- apnea
- bleeding
- cholestasis
- edema
- enterocolitis
- gastritis
- gastroesophageal reflux
- GI bleeding
- GI perforation
- heart failure
- hematuria
- hepatitis
- hyperbilirubinemia
- hyperglycemia
- hyperuricemia
- hypotension
- ileus
- infection
- injection site reaction
- intraventricular hemorrhage
- jaundice
- neutropenia
- oliguria
- prolonged bleeding time
- pulmonary hypertension
- renal failure (unspecified)
- seizures
- sinus tachycardia
- skin irritation
- skin ulcer
- thrombocytopenia
Monitoring Parameters
- CBC with differential
- echocardiogram
- hemoglobin/hematocrit
- LFTs
- platelet count
- serum bilirubin
- serum creatinine/BUN
Contraindications
- anemia
- anuria
- aortic coarctation
- bleeding
- breast-feeding
- coagulopathy
- congenital heart disease
- electrolyte imbalance
- extravasation
- GI bleeding
- GI perforation
- heart failure
- hepatic disease
- hypertension
- hypotension
- infants
- infection
- intracranial bleeding
- intramuscular administration
- jaundice
- necrotizing enterocolitis
- neonates
- oliguria
- pregnancy
- renal failure
- renal impairment
- subcutaneous administration
- surgery
- thrombocytopenia
Interactions
- Alprostadil
- Amikacin
- Aminoglycosides
- Gentamicin
- Kanamycin
- Loop diuretics
- Nonsteroidal antiinflammatory drugs
- Paromomycin
- Plazomicin
- Potassium-sparing diuretics
- Streptomycin
- Thiazide diuretics
- Tobramycin
