What are the outcomes of using paracetamol versus ibuprofen for PDA in preemies?
Patent ductus arteriosus (PDA) is a heart condition common in preterm infants where a blood vessel fails to close after birth. Doctors often use medication to close it, and two common options are paracetamol (acetaminophen) and ibuprofen. Research shows both drugs work about equally well, but paracetamol may have fewer side effects.
What the research says
A 2022 Cochrane review found that paracetamol is as effective as ibuprofen for closing a PDA in preterm infants, with similar rates of successful closure 6. The review also noted that paracetamol may cause fewer adverse effects, such as gastrointestinal bleeding or kidney impairment, compared to ibuprofen 6. A 2020 Cochrane review on ibuprofen confirmed its effectiveness but highlighted potential side effects like reduced blood flow to organs 7. A retrospective study from 2016-2019 reported that among 60 preterm infants treated for PDA, both paracetamol and ibuprofen were used, and the study aimed to identify predictors of response 3. Overall, the evidence suggests that paracetamol is a reasonable alternative to ibuprofen, especially when concerns about side effects exist.
What to ask your doctor
- Which medication does the evidence suggest is best for my baby's specific situation?
- What are the potential side effects of paracetamol versus ibuprofen for PDA closure?
- How will you monitor my baby's response to treatment?
- Are there any reasons my baby should not receive one of these medications?
- What happens if the medication does not close the PDA?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.