title: Acetaminophen for patent ductus arteriosus.
abstract: OBJECTIVE
  To evaluate the literature describing acetaminophen use in treatment of patent ductus arteriosus (PDA).
  
  
  METHODS
  Searches were conducted in MEDLINE with full text (EBSCOhost; 1946 to September 2014) using the search terms acetaminophen, paracetamol, and patent ductus arteriosus. The references of identified articles were reviewed to identify other relevant articles.
  
  
  METHODS
  Human clinical trials and case reports limited to the English language were reviewed. In all, 12 case reports and 2 randomized, controlled clinical trials explored the use of acetaminophen in treating PDA.
  
  
  RESULTS
  The case reports described the use of oral or intravenous acetaminophen in patients with contraindications to or who had previously failed nonsteroidal anti-inflammatory drug therapy for PDA. More than 76% of patients achieved successful PDA closure in reported cases. The clinical trials compared the efficacy of oral acetaminophen versus oral ibuprofen in preterm infants. Acetaminophen was noninferior to ibuprofen, with closure rates from 72.5% to 81.2%. The acetaminophen dose used in most case series and trials was 15 mg/kg dose every 6 hours for 3 days. Acetaminophen therapy was well tolerated, with only a few incidents of elevated liver enzymes being reported.
  
  
  CONCLUSIONS
  Oral acetaminophen is an alternative to PDA therapy in preterm infants when indomethacin/ibuprofen is not effective or is contraindicated, and it may be considered before surgical ligation.
authors.affiliation: Southwestern Oklahoma State University College of Pharmacy, Weatherford, OK, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Le
authors.affiliation: Southwestern Oklahoma State University College of Pharmacy, Weatherford, OK, USA Integris Baptist Medical Center, Oklahoma City, OK, USA mark.gales@swosu.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gales
authors.affiliation: Southwestern Oklahoma State University College of Pharmacy, Weatherford, OK, USA Integris Baptist Medical Center, Oklahoma City, OK, USA.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Gales
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature
chemical_list: D016861:Cyclooxygenase Inhibitors; D000082:Acetaminophen
keywords: acetaminophen; neonates; paracetamol; patent ductus arteriosus