Palliative therapy to temporarily maintain the potency of ductus arteriosus until corrective or palliative surgery in neonates who have a ductus-dependent congenital heart defect, including but not limited to mitral atresia, pulmonary atresia & stenosis, tricuspid atresia, tetralogy of Fallot, aortic arch interruption, aorta coarctation, transposition of the great vessels w/ or w/o other defects.
IV/Intra-arterial Initially 0.05-0.1 mcg/kg by continuous IV infusion into a large vein. Alternatively, may be administered through an umbilical artery catheter w/ its tip positioned at the ductal opening. After therapeutic response is achieved (increased pO2 in infants w/ restricted pulmonary blood flow or increased systemic BP & blood pH in infants w/ restricted systemic blood flow), reduce infusion rate to provide the lowest possible dosage that maintains the response. Increase up to 0.4 mcg/kg/min if response to 0.1 mcg/kg/min is inadequate.
Immediately decrease rate of infusion if arterial pressure fall significantly. May occur apnea in neonates weighing <2 kg at birth, & appears during 1st hr of drug infusion. Cortical proliferation of long bones may occur during long-term infusions. History of bleeding tendencies. Neonates w/ resp distress syndrome. Closely monitor signs of antral hyperplasia & gastric outlet obstruction in neonates receiving treatment at recommended dose for >120 hr. Intermittently monitor arterial pressure by umbilical artery catheter, auscultation, or w/ a Doppler transducer.
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