SOP 32: NCU page 1

Drug Indications and Dosages

Drug Dosage Route Comment
- Indications: Apnoea of
prematurity, RDS
Loading dose: Slow IV (over - Contraindications:
5 mg/kg slowly 10 min) or Convulsions, HIE
orally - Dilution: 1 ml Aminophylline
+ 9 ml normal saline or water
Aminophylline for injection
Maintenance dose (start 12 Slow IV - Oral administration: Only if
hours after loading dose): or orally feeding is tolerated well
- Duration: Until the baby is
1 – 3 mg/kg bd free of apnoea for several
days

Loading dose: 20 mg/kg stat Slow IV or

orally - Indication: Apnoea of
Caffeine prematurity, RDS
Maintenance dose (start 12 Slow IV or - Caffeine is preferred over
citrate
hours after loading dose): orally Aminophylline, if available
2.5 mg/kg bd

0.01 mg/kg/dose = - Indications:

Quick IV Cardiopulmonary
0.1 ml/kg/dose of 1:10 resuscitation with asystole or
Adrenaline dilution Alternatively: bradycardia < 60 bpm
Intraosseous - Dilution:
Repeat after 2 – 5 min if 1 ml Adrenaline + 9 ml normal
(IO)
necessary saline or water for injection

- Indications: Heart failure

1-2 mg/kg/day Slow IV or
Furosemide associated with PDA or
in 2 divided doses orally acyanotic heart disease

- Indications: Heart failure

1-2 mg/kg/day
Spironolactone Orally associated with PDA or
in 2 divided doses acyanotic heart disease

First dose: 10 mg/kg - Indication: Closure of PDA

Second dose after 24 hours: - Contraindication: Bleeding,
platelet count < 60, poor
Ibuprofen 5 mg/kg Orally urine output, signs of NEC
Third dose 48 hours after - Doses should be 24 hours
apart
first: 5 mg/kg

MoHCDGEC (2019) National Guideline for Neonatal Care and Establishment of Neonatal Care Unit,
p 21-22; 45;68; 76; 99-100; 105; 128; 134; 224-225;
SOP 32: NCU page 2

Drug Indications and Dosages

Drug Dosage Route Comment
Loading dose: 20 mg/kg Slow IV (over 5
If still convulsing 10 mg/kg minutes) or IM
can be added after 30 min
- Indication: Convulsions
(max. twice)
- Dilution:
Phenobarbitone Maintenance dose (start 24
1 ml Phenobarbitone +
Slow IV 9 ml normal saline or
hours after loading dose): or oral tablets water for injection
5 mg/kg OD or in 2 divided
doses; end by tapering over 2
days

Loading dose: 15-20 mg/kg

Maintenance dose (start 24

hours after loading dose):
- Indication: 2nd line
- 10 mg/kg/day in 2 divided Slow IV over treatment of convulsions
Levetiracetam doses 15-20 min or in newborns
- Weekly increase by 5-10 orally - If orally: administer via
gastric tube
mg/kg/day
- Typical maintenance dose
30-40 mg/kg/day, max. 60
mg/kg/day

Loading dose: 20 mg/kg - Indications: 3rd line

treatment of convulsions
Phenytoin Maintenance dose (start 12 Slow IV in newborns
hours after loading dose): 2-4 - Caution: Cardiac
monitoring is required!
mg/kg/day in 2 divided doses

Apply to the
100,000 IU 6 hourly (continue baby’s mouth
Nystatin for 2 days after the lesions have and to the - Indication: Oral thrush
healed) nipples after
breastfeeding

Apply to the
6 hourly - Indications: Oral thrush;
baby’s mouth
diaper thrush
Miconazole gel (continue for 2 days after the and to the
- Miconazole is an
lesions have healed) nipples after
alternative to Nystatin
breastfeeding

MoHCDGEC (2019) National Guideline for Neonatal Care and Establishment of Neonatal Care Unit,
p 21-22; 45;68; 76; 99-100; 105; 128; 134; 224-225;
SOP 32: NCU page 3

Drug Indications and Dosages

Drug Dosage Route Comment
Prophylaxis: Topical (Inside
1 % tetracycline eye the lower lid
beginning with - Indications: Prophylaxis
ointment stat
for all newborn infants
Tetracycline eye the side of the
(to prevent eye infections)
ointment Treatment: nose and and treatment of eye
1 % tetracycline eye extending to the infections
ointment 6 hourly opposite side of
for 7 days the lid)

Prophylaxis:
- 1 mg stat for newborn
≥ 1500 g
IM or IV (in - Indication: Vitamin K
Vitamin K1 - 0.5 mg stat for newborn
case of deficiency prophylaxis in
(Phytomenadione) < 1500 g all newborn infants
treatment)
Treatment (in case of
bleeding): 2 mg IV OD for 3
days

2 – 4 mg/kg/day in 2-3 - Indication: Prophylaxis

divided doses; starting at 3 for all LBW/prematures
Elemental Iron Orally - Check Hb at follow-up
weeks until 3 – 9 months of visits to decide on
age duration

Dose depends on the

Multivitamins manufacturer Orally
- Indication: Prophylaxis
for all LBW/prematures
Duration: 6 months

10 mg/kg orally OD
Isoniazid Orally - Indication: TB exposure
for 6 months

MoHCDGEC (2019) National Guideline for Neonatal Care and Establishment of Neonatal Care Unit,
p 21-22; 45;68; 76; 99-100; 105; 128; 134; 224-225;