• Route IV, oral Preparation/Dilution
  • 3 hours
  • Neonatal Intensive Care Drug Manual




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    Dosage/Interval


    IV:

    Loading: 0.4 mg/kg administered over THREE hours followed by:

    Maintenance: 1.6 mg/kg/day (0.067 mg/kg/hour) as a continuous infusion for up to 7 days.

    PO:

    Start at 0.5 to 1 mg/kg/dose given 6 to 8 hourly and titrate up to 2 mg/kg/dose according to response.

    May increase up to maximum of 3 mg/kg/dose given 6 hourly.
    To avoid the possible occurrence of sudden clinical deterioration during withdrawal of sildenafil, a gradual dose reduction should be considered when stopping sildenafil.


    Route

    IV, oral

    Preparation/Dilution

    See below

    Administration


    IV infusion:

    Low concentration IV infusion (weight > 2.5 kg)

    Draw up 2.5mL/kg (2 mg/kg of sildenafil) solution and make up to 15 mL using glucose 5% (preferred) or sodium chloride 0.9%.


    Infuse 1 mL/h for 3 hours (loading dose of 0.4 mg/kg) followed by 0.5 mL/h (0.067 mg/kg/h)
    High concentration IV Infusion (weight ≤ 2.5 kg)

    Draw up 4.2mL/kg (3.36 mg /kg of sildenafil) solution and make up to 15 mL using glucose 5% (preferred) or sodium chloride 0.9%.


    Infuse 0.6 mL/h for 3 hours(loading dose of 0.4 mg/kg) followed by 0.3 mL/h (0.067 mg/kg/h)
    Oral:

    Shake well before drawing up the dose. Give via intragastric tube, preferably with feed to minimise risk of gastrointestinal irritation. If baby is not on enteral feeds or breast milk is not available, give dose via intragastric tube and flush with 0.5 mL water for injection.



    Monitoring


    Heart rate, blood pressure and oxygenation.

    Renal and hepatic function.

    Consider monitoring with echocardiogram.



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    Neonatal Intensive Care Drug Manual

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