Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
August 2005
Revised Date: 
September 2011
  • Maintenance of the patency of ductus arteriosus in neonates until surgery can be performed
  • Pulmonary hypertension in infants/children with congenital heart defects with left-to-right shunts
Reconstitution and Stability: 
  • Available as a 500 mcg/mL solution
  • Store in fridge
  • Diluted solution stable 24 hours at room temperature.



- Solutions Compatible:  D5W, D10W, NS

- Additives/Above Cassette Compatible: caffeine

- Y-site Compatible: atropine, clindamycin, dexamethasone, digoxin, diphenhydramine, dopamine, epinephrine, furosemide, gentamicin, heparin, hydrocortisone, lidocaine, midazolam, morphine, pancuronium, phenobarbital, KCl (20 mmol/L), ranitidine

- Incompatible: levofloxacin



(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct NO
IV Intermittent Infusion NO
IV Continuous Infusion

YES, into large vein or through an umbilical artery catheter placed at the ductal opening
Standard Concentration in ER/OR/PICU: 10 mcg/mL

Click here to access SDC Drug Infusion Sheet


(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Neonates and Infants:

                 Initial:  0.05-0.1 mcg/kg/minute
                         - with therapeutic response, reduce rate to lowest effective dosage
                         - with unsatisfactory response, increase rate gradually

                Maintenance:  0.01-0.4 mcg/kg/minute

Potential hazards of parenteral administration: 
  • Apnea:  (10-12% of neonates), fever, flushing (with rapid rates of administration)
  • Hypotension, brady/tachycardia
  • Seizures
  • Hypoglycemia, hypocalcemia, hypo/hyperkalemia
  • Thrombocytopenia
  • Gastric-outlet obstruction with prolonged infusions (> 120 hours)
  • Extravasation may cause tissue sloughing and necrosis
  • Use only if facilities for intubation and ventilation are available
  • Monitor RR, HR, BP, temperature, pO2, arterial pressure

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