What is the drug of choice for treating patent ductus arteriosus (PDA)?

Indomethacin is considered the drug of choice for treating patent ductus arteriosus (PDA), particularly in premature infants. This non-steroidal anti-inflammatory drug (NSAID) works by inhibiting cyclooxygenase, which reduces the production of prostaglandins. Prostaglandins play a crucial role in maintaining the patency of the ductus arteriosus. By decreasing prostaglandin levels, indomethacin facilitates the closure of the ductus arteriosus.

Indomethacin's effectiveness in this condition is particularly evident in the neonatal population, where it can lead to significant clinical improvements and is often used as the first line of medical therapy for PDA in premature infants. The timing of initiation and the dosage must be appropriately managed to ensure optimal outcomes while minimizing potential side effects.

While ibuprofen, another NSAID, is also used in some cases for PDA and may similarly work to promote closure by reducing prostaglandin levels, indomethacin has a more established track record for treating PDA, especially when initiated very early in the life of the infant.