Reviewed by Dr David Knight
September 2007
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page


Management of  Indomethacin Administration




Slow IV Infusion

  1. Reconstitution (no powder displacement).
  2. Do NOT further dilute as indomethacin becomes very unstable.
  3. Draw up into 1ml syringe.
  4. Administer by slow IV infusion over 30 minutes using a syringe pump. Filter prior to administration through a 5 micron filter.
  5. Is compatible with 0.9% NaCl and water only.
  6. Do NOT mix with other drugs, IV solutions, blood or blood products.
  7. Ensure the dead space in the IV tubing is considered when administering the very small volumes of indomethacin.
  8. Flush with 0.9% NaCl before and after administration of indomethacin.

Observation and Documentation

  1. Assess for signs of adverse effects.
  2. Maintain strict fluid balance. Report urinary output of<1-2 m1/kg/hour to doctor / NS-ANP.
  3. Perform urinalysis 8 hourly for blood, specific gravity and protein.
  4. Observe for evidence of bleeding.
  5. Assess for signs and symptoms of PDA. Auscultate for PDA closure.
  6. Monitor blood pressure at least 4 hourly.



1 Douidar SM, Richardson J, Snodgrass WR. Role of indomethacin in ductus closure: An update evaluation. Dev Pharmacol Ther 1988; 11:196-212.
2 Hammerman C, Aramburo MJ. Prolonged indomethacin therapy for the prevention of recurrences of patent ductus arteriosus. J Pediatr 1990; 117:771-6.
3 Shar N, Lindstrom DP, Cotton RB. Effect of slow infusion of indomethacin on cerebral blood flow in premature infants. Pediatr Res 1990; 27:225A.