Oral Aqueous Suspension of Indomethacin Should Be Abandoned

Abstract

Despite considerable clinical and experimental data that indomethacin can close the patent ductus arteriousus (PDA) in human newborns, reports of therapeutic failures have been published. Brash et al1 note pharmacokinetic vagaries after intravenous administration and these relate to clinical response, but most previous reports discuss orally administered indomethacin. There may be a simple pharmacologic explanation for some therapeutic failures after oral indomethacin in the newborn. In published papers, and in many nurseries, indomethacin is usually prepared by dissolving the contents of one 25-mg capsule in 10 ml of distilled water.