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GENITO URINARY SYSTEM AND SEX HORMONES › OTHER GYNECOLOGICALS › UTEROTONICS › Ergot alkaloids and oxytocin incl. analogues, in combination
methylergometrine and oxytocin
G02AC01
Forms & Strengths
- Fixed-dose combination preparations containing methylergometrine maleate and oxytocin (availability varies by global region, commonly as solution for injection)
Adult Dosing
- Postpartum hemorrhage prevention/treatment: Administered strictly per specific regional product labeling and institutional obstetric protocols, typically as a single intramuscular or slow intravenous injection following delivery of the placenta
Pediatric Dosing
- Not applicable (agents used exclusively for obstetric management in postpartum patients)
Indications
- Prevention and treatment of postpartum hemorrhage due to uterine atony following the third stage of labor
Mechanism of Action
- Synergistic uterotonic effect combining the direct stimulation of myometrial smooth muscle receptors by oxytocin with the sustained tetanic uterine contractions induced by methylergometrine via partial agonist activity at 5-HT2 and alpha-adrenergic receptors
Contraindications
- First and second stages of labor (prior to delivery of the child)
- Hypertension, severe preeclampsia, or eclampsia
- Known hypersensitivity to methylergometrine, oxytocin, or ergot alkaloids
- Vascular disease, coronary artery disease, or peripheral vascular disease
- Sepsis
Adverse Reactions
- Hypertension (potentially severe, especially with methylergometrine)
- Nausea and vomiting
- Uterine pain and cramping
- Headache and dizziness
- Chest pain, palpitations, or bradycardia
- Water intoxication and hyponatremia (associated with prolonged high-dose oxytocin infusions)
Drug Interactions
- Potent CYP3A4 inhibitors (e.g., macrolide antibiotics, protease inhibitors): May increase plasma concentrations of methylergometrine, elevating toxicity risks such as vasospasm and ergotism
- Vasoconstrictors and ergot alkaloids: Concomitant use significantly increases the risk of severe hypertension and cerebral hemorrhage
- Prostaglandins: May potentiate uterotonic effects, requiring careful monitoring
Curated Content: Needs Vetting Before Put to Clinical Use