Ergometrine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Post-partum and post-abortion bleeding 0.2-0.4 mg 2-4 times/day until danger of uterine atony and haemorrhage has passed. Max duration: 1 wk postpartum. IV Excessive uterine bleeding 200 mcg over at least 1 min, followed by oral doses of 200-400 mcg 2-4 times/day until the danger of atony or haemorrhage has passed. IM Active management of 3rd stage of labour 500 mcg given with 5 units of oxytocin after delivery of the anterior shoulder or immediately after delivery  of the infant.  Postpartum haemorrhage 200-500 mcg following expulsion of the placenta or when bleeding occurs.
Dosage Details
Intramuscular
Active management of the third stage of labour
Adult: 500 mcg given with 5 units of oxytocin after delivery of the anterior shoulder or immediately after delivery  of the infant.

Intramuscular
Treatment and prophylaxis of postpartum haemorrhage
Adult: 200-500 mcg following expulsion of the placenta or when bleeding occurs.

Intravenous
Excessive uterine bleeding
Adult: 200 mcg via IV inj over at least 1 minute. May follow with oral doses of 200-400 mcg 2-4 times daily until the danger of atony or haemorrhage has passed (usually 48 hr).

Oral
Postpartum and post-abortion bleeding
Adult: 0.2-0.4 mg 2-4 times daily until danger of uterine atony and haemorrhage has passed (usually 48 hr). Max duration: 1 wk postpartum.
Contraindications
Pregnancy, 1st and 2nd stage of labour, patients with preeclampsia, eclampsia or threatened spontaneous abortion; porphyria.
Special Precautions
Breech and abnormal foetal presentation; hypertension; chronic anaemia; hepatic, renal, respiratory or cardiac impairment; toxemia; lactation; hypocalcaemia. Monitor BP, pulse and uterine response.
Adverse Reactions
Nausea, vomiting, abdominal pain, diarrhoea; headache, dizziness; tinnitus; chest pain, palpitation, bradycardia, transient hypertension and other cardiac arrhythmias; dyspnoea, sometimes rashes, shock.
Potentially Fatal: MI, pulmonary oedema.
Overdosage
Symptoms include peripheral vasoconstriction, encephalopathy, convulsions, respiratory failure, acute renal failure and temporary lactose intolerance. Treatment is supportive.
Drug Interactions
Halothane causes relaxation of uterine muscle and may interfere with ergometrine action. Enhanced uterotonic effect with prostaglandins and oxytocin. Concurrent admin with CYP3A4 inhibitors may lead to vasospasm, cerebral ischaemia and/or ischaemia of extremities.
Potentially Fatal: Enhanced vasoconstrictive effects with sympathomimetics and other vasoconstrictors.
Action
Description: Ergometrine causes contraction of the uterine muscle. At low doses, there is an increase in frequency and amplitude of contractions while at higher doses, the basal tone of the uterus is increased. Ergometrine also causes vasoconstriction of peripheral and cerebral vessels.
Onset: 5-15 min (oral); 2-7 min (IM).
Pharmacokinetics:
Absorption: Rapid absorption from the GI tract (oral).
Metabolism: Hepatic.
Storage
Intramuscular:
Active management of the third stage of labour: Refrigerate at 2-8°C.
Intravenous:
Refrigerate at 2-8°C.
Oral:
Store below 25°C.
Disclaimer: This information is independently developed by MIMS based on Ergometrine 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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