Ibuprofen lysine

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

  1. anemia
  2. apnea
  3. bleeding
  4. cholestasis
  5. edema
  6. enterocolitis
  7. gastritis
  8. gastroesophageal reflux
  9. GI bleeding
  10. GI perforation
  11. heart failure
  12. hematuria
  13. hepatitis
  14. hyperbilirubinemia
  15. hyperglycemia
  16. hyperuricemia
  17. hypotension
  18. ileus
  19. infection
  20. injection site reaction
  21. intraventricular hemorrhage
  22. jaundice
  23. neutropenia
  24. oliguria
  25. prolonged bleeding time
  26. pulmonary hypertension
  27. renal failure (unspecified)
  28. seizures
  29. sinus tachycardia
  30. skin irritation
  31. skin ulcer
  32. 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
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