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methylergometrine

G02AB01

Forms & Strengths

Injectable solution: 0.2 mg/mL
Oral tablet: 0.2 mg

Adult Dosing

Postpartum hemorrhage (IV/IM): 0.2 mg administered after delivery of the placenta or anterior shoulder; may repeat every 2-4 hours as needed, up to a maximum of 5 doses.
Postpartum hemorrhage (Oral): 0.2 mg every 6 to 8 hours for a maximum of 7 days.

Pediatric Dosing

Not indicated for pediatric use.

Indications

Routine management of postpartum hemorrhage due to uterine atony following delivery of the placenta.
Postpartum subinvolution when accompanied by uterine atony.

Mechanism of Action

Direct stimulation of smooth muscle of the uterus, increasing tone, rate, and amplitude of contractions, thereby reducing postpartum bleeding.

Contraindications

Hypertension
Toxemia/preeclampsia
Hypersensitivity to ergot alkaloids
Pregnancy (prior to delivery of the placenta)

Adverse Reactions

Hypertension (sometimes severe)
Nausea and vomiting
Headache
Dizziness
Chest pain or palpitations
Cramps

Drug Interactions

Potent CYP3A4 inhibitors (e.g., macrolide antibiotics, protease inhibitors, azole antifungals) increase ergot toxicity risk causing vasospasm and ischemia.
Triptans or other ergot alkaloids may lead to additive vasoconstrictive effects and severe hypertension.
Vasoconstrictor medications can cause excessive blood pressure elevation.

Curated Content: Needs Vetting Before Put to Clinical Use