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Sildenafil Citrate Overdose in a 3-Month Postterm Premature Infant With Pulmonary Artery Hypertension

Marjolein van Heugten1, Lonneke van Onzenoort-Bokken

  • 1From the Department of Paediatrics, Máxima Medical Centre, Veldhoven, the Netherlands.

Pediatric Emergency Care
|June 8, 2021
PubMed

Insights

A premature infant experienced an accidental sildenafil overdose but showed only mild symptoms. This case highlights that sildenafil overdose can be well-tolerated in infants, even with underlying health conditions.

Area of Science:

  • Pediatric Pharmacology
  • Neonatal Toxicology
  • Clinical Case Reports

Background:

  • Sildenafil is used for pulmonary hypertension in neonates.
  • Infants have a longer drug elimination half-life.
  • Premature infants may have underlying cardiac and pulmonary conditions.

Observation:

  • A premature infant with bronchopulmonary dysplasia, corrected congenital heart disease, and pulmonary hypertension experienced an accidental sildenafil overdose.
  • The infant received a relatively high dose of sildenafil.
  • The patient was medically frail.

Findings:

  • Despite the high dose and infant pharmacokinetics, the patient exhibited only mild symptoms of sildenafil overdose.
  • The infant's recovery was uneventful.
  • The patient was discharged home after a short observation period.

Implications:

  • Sildenafil overdose, while potentially serious, may be well-tolerated in specific pediatric cases.
  • Management of sildenafil intoxication in neonates can be guided by pharmacokinetic data.
  • This case underscores the importance of individualized patient assessment in managing medication overdoses.
Abstract

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