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Updated: Jun 8, 2026

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Effect of ibuprofen on bilirubin-albumin binding affinity in premature infants

Sanjiv B Amin1, Nicholas Miravalle

  • 1Division of Neonatology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA. Sanjiv_Amin@urmc.rochester.edu

Journal of Perinatal Medicine
|October 20, 2010
PubMed

Insights

Ibuprofen did not significantly alter bilirubin-albumin binding or increase unbound bilirubin in premature infants with hyperbilirubinemia. This suggests ibuprofen is likely safe for this patient population regarding bilirubin displacement.

Area of Science:

  • Neonatalogy
  • Pharmacology
  • Biochemistry

Background:

  • Unconjugated hyperbilirubinemia is common in premature infants.
  • Ibuprofen is used for patent ductus arteriosus in neonates.
  • Concerns exist regarding ibuprofen's potential to displace bilirubin from albumin.

Purpose of the Study:

  • To assess the impact of ibuprofen on bilirubin-albumin binding affinity.
  • To determine if ibuprofen affects unbound bilirubin levels in premature infants.

Main Methods:

  • Prospective study design with infants serving as their own controls.
  • Inclusion of premature infants (<30 weeks gestational age) with unconjugated hyperbilirubinemia receiving ibuprofen.
  • Measurement of total serum bilirubin and unbound bilirubin before and after ibuprofen initiation; calculation of bilirubin/albumin binding constant.

Main Results:

  • Ten infants were studied.
  • No significant changes in total serum bilirubin, unbound bilirubin, or bilirubin/albumin binding constant were observed after ibuprofen administration.
  • The ratio of unbound bilirubin with and without ibuprofen (0.88) indicated no significant displacing effect.

Conclusions:

  • Ibuprofen does not appear to displace bilirubin from albumin in stable premature infants with mild to moderate unconjugated hyperbilirubinemia.
  • The findings suggest ibuprofen may be safely used in this population without increasing the risk of bilirubin-induced neurotoxicity due to displacement.
Abstract

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