Intravenous ibuprofen is being studied in sick, premature infants for the prevention of intraventricular haemorrhage and closure of the ductus arteriosus. We tested the effect of ibuprofen on bilirubin-albumin binding in adult and newborn infant serum by measuring the free ibuprofen concentration in the presence of bilirubin (reverse displacement method). At clinically appropriate ibuprofen concentrations the free fraction of bilirubin is increased by a factor of 4. Ibuprofen may increase the risk of bilirubin encephalopathy when used in sick, premature infants.
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