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Clearance ↑ after birth

also affected by

weight, age.

t1/2: 20–24 h (newborn)

vs. 2 h (adults)

IV, Oral tablets,

solutions

Oral: 4–10 mg q6–8h as

needed

Limit: 40 mg/kg/d

IV: Ibuprofen lysine:

10 mg/kg then two

doses: 5 mg/kg at 24 h

and at 48 h “off label”

for analgesia.

No data regarding use

>3 d.

None:

Maintain hydration,

avoid use of nephrotoxins.

Discontinue anticoagulants, replace

blood loss if

needed, correct

low platelets.

Oral solutions may contain benzoate

“gasping syndrome” in newborn.

IV: No data for analgesic dosing for

newborns.

IV ibuprofen lysine is labeled for PDA

closure.

Limited data on use of ibuprofen analgesia for infants <3 mo of age; monitor urine output, renal function.

Calderol 400 mg/4 mL AWP (USD)

$8.82/vial. Not labeled for <17 yr of age.

IV ibuprofen.e,f,g

NSAID precautions: Use lowest effective dose for shortest duration possible

May displace bilirubin. Caution in

asthma, renal or hepatic insufficiency,

bleeding disorders, GI disease (bleeding or ulcers), and those patients

receiving anticoagulants. Use of ≥1

NSAID not recommended.

All NSAIDs have potential adverse

cardiovascular effects.

High incidence of renal and GI side

effects reported with use of ibuprofen

to treat patent ductus arteriosus (PDA):

NSAIDS not recommended for routine

analgesic use in neonate.

Table

A.2 Sedative and Analgesic Agents Commonly Used in Pediatrics

402

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