Efficacy and safety of oral versus intravenous ibuprofen in very low birth weight preterm infants with patent ductus arteriosus

J Pediatr. 2011 Apr;158(4):549-554.e1. doi: 10.1016/j.jpeds.2010.10.008. Epub 2010 Nov 20.


Objective: To compare oral ibuprofen with intravenous ibuprofen for closure of patent ductus arteriosus in very low birth weight (VLBW) preterm infants.

Study design: In a prospective, randomized study, 102 VLBW preterm infants with patent ductus arteriosus received either intravenous or oral ibuprofen at an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 hours. The success rate and evaluation of renal tolerance using cystatin-C were the major outcomes.

Results: Patent ductus arteriosus closure rate was significantly higher with oral ibuprofen (84.6% versus 62%) after the first course of the treatment (P = .011). The cystatin-C level increased significantly after treatment in the oral group (P = .001), but did not change with intravenous ibuprofen (P = .4).

Conclusions: Oral ibuprofen is more effective than intravenous ibuprofen for ductal closure in VLBW infants. The increase in the cystatin-C level with oral treatment suggests that patients with borderline renal function should be evaluated and followed closely.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Bilirubin / blood
  • Cyclooxygenase Inhibitors / administration & dosage*
  • Cystatin C / blood
  • Ductus Arteriosus, Patent / diagnostic imaging
  • Ductus Arteriosus, Patent / drug therapy*
  • Echocardiography, Doppler
  • Humans
  • Ibuprofen / administration & dosage*
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / drug therapy*
  • Infant, Very Low Birth Weight
  • Infusions, Intravenous
  • Kidney Function Tests
  • Prospective Studies
  • Treatment Outcome


  • Cyclooxygenase Inhibitors
  • Cystatin C
  • Bilirubin
  • Ibuprofen