Response to the Comment on ‘Prostaglandin <scp>E1</scp> Infusions for Duct‐Dependent Congenital Heart Defects Can Cause Severe Ethanol Intoxication’

We thank the authors for the thoughtful comment [1] on our article [2] addressing ethanol intoxication associated with prostaglandin E1 infusion in neonate. We fully agree with this. At present, there are no real-world data on ethanol blood levels in infants receiving prostaglandin E1 infusions for maintaining patency of the ductus arteriosus. We do not know whether increased levels are found in infants who remain seemingly asymptomatic during treatment, nor do we know which ethanol levels may be associated with potential side-effects. Importantly, the potential long-term effects of prolonged low-level ethanol exposure on neurodevelopmental outcomes remain unknown. Clearly, further research is urgently needed to address those questions in the vulnerable patient population in our NICUs and PICUs. Unfortunately, a prostaglandin E1 formulation without ethanol is not available. Therefore, risk mitigation strategies should include (1) use of the lowest effective prostaglandin E1 doses and (2) surgical or interventional treatment as early as clinically feasible. Finally, we strongly support the suggestion that the ethanol content of prostaglandin E1 preparations should be clearly and prominently stated in the product information to raise awareness among clinicians and to facilitate informed risk–benefit discussions. Helgi Padari: writing – original draft. Stefan Johansson: writing – original draft. This article is linked to Padari and Johansson, and Shaniv and Lavon papers. To view these articles, visit https://doi.org/10.1111/apa.70424 and https://doi.org/10.1111/apa.70480. Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.