Intravenous frusemide does not interact pharmacodynamically with acetaminophen in critically ill preterm neonates with patent ductus arteriosus

K. Sridharan, A. Al Madhoob, M. Al Jufairi, E. Al Ansari, R. Al Marzooq

Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain. skannandr@gmail.com

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• Pharmacology

OBJECTIVE: Evidence is controversial regarding the effect of concomitant frusemide with acetaminophen therapy in neonates with patent ductus arteriosus (PDA).

PATIENTS AND METHODS: Critically ill neonates diagnosed with hemodynamically significant PDA by echocardiography and receiving intravenous acetaminophen were recruited. Dosing regimens of frusemide, and acetaminophen, and the sizes of ductus arteriosus following treatment, were evaluated.

RESULTS: Fifty-one neonates were recruited. Forty-six (90.2%) had moderate-sized, and five (9.8%) had large-sized ductus arteriosus. Forty (78.4%) neonates had a successful closure. Twenty-four received concomitant frusemide with a median (range) cumulative dose of 3 (0.8-13) mg; duration of 2 (1-13) days; and a fraction of overlapping days with acetaminophen therapy of 0.4 (0.2-1). Twenty-one (87.5%) neonates that received frusemide had a successful ductal closure compared to 70.4% of those without (p >0.05).

CONCLUSIONS: We did not observe any significant influence in the outcomes of acetaminophen therapy with concomitant frusemide in preterm neonates with PDA.

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