Methylergometrine


Concise Prescribing Info
Indications/Uses
Postpartum haemorrhage.
Dosage/Direction for Use
Adult : PO During the puerperium 0.2 mg 3 or 4 times daily for 1 week. IM/IV After delivery of the anterior shoulder or placenta, or during the puerperium: 0.2 mg. Doses may be repeated every 2-4 hours as necessary. In emergencies, the same dose may be given via slow IV infusion over 1 minute.
Dosage Details
Oral
Postpartum haemorrhage
Adult: During the puerperium: 0.2 mg 3 or 4 times daily for 1 week.

Parenteral
Postpartum haemorrhage
Adult: After delivery of the anterior shoulder or placenta, or during the puerperium: 0.2 mg via IM inj. Doses may be repeated every 2-4 hours as necessary. In emergencies, the same dose may be given via slow IV infusion over 1 minute.
Contraindications
Hypersensitivity, hypertension, preeclampsia. Pregnancy.
Special Precautions
Patient with sepsis, coronary artery disease (CAD), obliterative vascular disease. Use during the second stage of labour. Renal and hepatic impairment. Lactation.
Adverse Reactions
Significant: Hypertension, myocardial ischaemia, MI; ergotism, pleural fibrosis, retroperitoneal fibrosis (prolonged use).
Cardiac disorders: Chest pain, bradycardia, tachycardia, palpitation, coronary arterial spasm.
Ear and labyrinth disorders: Tinnitus.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain.
Immune system disorders: Anaphylaxis.
Metabolism and nutrition disorders: Water intoxication.
Musculoskeletal and connective tissue disorders: Leg cramps.
Nervous system disorders: Dizziness, headache, dysgeusia, seizure.
Psychiatric disorders: Hallucination.
Renal and urinary disorders: Haematuria.
Respiratory, thoracic and mediastinal disorders: Dyspnoea, nasal congestion.
Skin and subcutaneous tissue disorders: Rash, diaphoresis.
Vascular disorders: Vasoconstriction, vasospasm, thrombophlebitis, hypotension.
IM/IV/Parenteral/PO: C
MonitoringParameters
Monitor blood pressure, CNS status, and vaginal bleeding.
Overdosage
Symptoms: Nausea, vomiting, abdominal pain, oliguria, tingling of the extremities, high blood pressure; hypotension, respiratory depression, hypothermia, convulsions. Management: Symptomatic and supportive treatment. Remove offending drug by inducing emesis, gastric lavage, catharsis, or supportive diuresis. Maintain adequate pulmonary ventilation, especially if convulsion or coma develop. Use standard anticonvulsant agents to control convulsion. Correct hypotension with pressor drugs. Treat peripheral vasospasm by applying warmth to the extremities as necessary.
Drug Interactions
Increased risk of ergot toxicity with CYP3A4 inhibitors (e.g. erythromycin, clarithromycin, ritonavir, delavirdine, ketoconazole, itraconazole, voriconazole). Enhance vasoconstrictive effect with β-blockers. Diminished therapeutic effect with anaesthetics (e.g. halothane, methoxyflurane). Reduced therapeutic effect of glyceryl trinitrate and other antianginal medications.
Action
Description: Methylergometrine is an ergot alkaloid. It increases the tone, rate and amplitude of uterine contractions which shortens the third stage of labour and reduces blood loss.
Synonym: methylergonovine.
Onset: 5-10 minutes (oral); 2-5 minutes (IM).
Duration: Approx 3 hours (oral/IM).
Pharmacokinetics:
Absorption: Rapidly absorbed. Bioavailability: 60% (oral); 78% (IM). Time to peak plasma concentration: 0.3-2 hours (oral); 0.2-0.6 hours (IM).
Distribution: Enters breast milk. Volume of distribution: 39-73 L.
Metabolism: Undergoes extensive first-pass hepatic metabolism.
Excretion: Via the urine and faeces. Elimination half-life: Approx 3 hours.
Chemical Structure

Chemical Structure Image
Methylergometrine_01

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 8226, Methylergonovine. https://pubchem.ncbi.nlm.nih.gov/compound/Methylergonovine. Accessed Oct. 27, 2020.

Storage
Tab: Store between 20-25°C. Inj: Store between 2-8°C. Protect from light.
ATC Classification
G02AB01 - methylergometrine ; Belongs to the class of ergot alkaloids. Used to induce abortion or augment labour and to minimize blood loss from the placental site.
References
Anon. Methylergonovine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 02/09/2020.

Anon. Methylergonovine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/09/2020.

Buckingham R (ed). Methylergometrine Maleate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/09/2020.

Methylergonovine Maleate Injection (Breckenridge Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/09/2020.

Methylergonovine Tablet (Amneal Pharmaceuticals NY LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/09/2020.

Methylergonovine. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com/. Accessed 02/09/2020.

Disclaimer: This information is independently developed by MIMS based on Methylergometrine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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