[Pharmacologic treatment of neonatal jaundice. A new approach].

Abstract

Pharmacological treatment of neonatal jaundice is again topical. At the beginning of the eighties, clofibrate was added to phenobarbital which was difficult to use and inefficient. Clofibrate is a better enhancer of glucuronosyl transferase induction than phenobarbital and causes 100% increase of hepatic bilirubin clearance within 6 hours. In the treatment of early jaundice in full term neonate, it significantly reduces bilirubinemia in 16 hours, and decreases the intensity and duration of jaundice and also phototherapy requirement. At the end of the eighties, new molecules inhibiting hepatic production of heme to bilirubin, like metalloporphyrins, were introduced. These molecules block the transformation of heme to biliverdin and bilirubin. Among them, the Sn-mesoporphyrin seems to have the best efficacy when used prophylactically in premature infants between 30 and 36 weeks of gestational age, and also curatively in full-term neonates, with minimal side effects. However the product is not yet manufactured and can not be used in pediatrics practice. Therefore clofibrate represents the only pharmacological treatment of neonatal jaundice actually available.

• Authors: J C Gabilan
• Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie (Arch Pediatr) Vol. 5 Issue 11 Pg. 1274-8 (Nov 1998) ISSN: 0929-693X [Print] France
• Vernacular Title: Traitement pharmacologique de l'ictère du nouveau-né. Un nouvel essor.
• PMID: 9853069 (Publication Type: English Abstract, Journal Article)

Chemical References

• Enzyme Inhibitors
• Metalloporphyrins
• tin mesoporphyrin
• Clofibrate

Topics

• Clofibrate (administration & dosage, adverse effects)
• Combined Modality Therapy
• Enzyme Inhibitors (administration & dosage, adverse effects)
• Female
• Humans
• Infant, Newborn
• Jaundice, Neonatal (drug therapy)
• Metalloporphyrins (administration & dosage, adverse effects)
• Phototherapy
• Pregnancy
• Treatment Outcome