Effect of ibuprofen on bilirubin-albumin binding during the treatment of patent ductus arteriosus in preterm infant.

Ibuprofen carries the theoretical risk of increasing bilirubin encephalopathy by displacing bilirubin from albumin binding sites. Indeed, ibuprofen displaces bilirubin from albumin binding site at high concentrations in vitro. The first results in vivo seem to demonstrate no displacement of bilirubin in preterm infants treated by the current recommended doses of 10-5-5 mg/kg/day and when total bilirubin levels are below 10 mg/dL. However, this study does not provide information about possible risks of ibuprofen (IBU) use, when the bilirubin levels are higher than 10 mg/dL or if higher IBU doses are used.