Oxytocin + Ergometrine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Active management of 3rd stage of labour Each mL contains 5 IU oxytocin and 0.5 mg ergometrine maleate: 1 mL after delivery of the anterior shoulder, or latest, immediately after delivery of baby. 3rd stage of labour and postpartum haemorrhage Each mL contains 5 IU oxytocin and 0.5 mg ergometrine maleate: 0.5-1 mL via slow IV inj. IM Prevention and treatment of postpartum haemorrhage Each mL contains 5 IU oxytocin and 0.5 mg ergometrine maleate: 1 mL after placenta expulsion or when bleeding occurs.
Dosage Details
Intramuscular
Treatment and prophylaxis of postpartum haemorrhage
Adult: As combination product: Each ml containing 5 IU oxytocin and 0.5 mg ergometrine maleate: 1 ml after placenta expulsion or when bleeding occurs.

Intramuscular
Active management of the third stage of labour
Adult: As combination product: Each ml containing 5 IU oxytocin and 0.5 mg ergometrine maleate: 1 ml after delivery of the anterior shoulder, or latest, immediately after delivery of baby. Placenta expulsion to be assisted by gentle suprapubic pressure and controlled cord traction.
Contraindications
1st stage of labour, primary or secondary uterine inertia. 2nd stage of labour head crowning of head. Severe heart, liver or kidney disease; occlusive vascular disease; sepsis; severe hypertension; pre-eclampsia; eclampsia. Pregnancy.
Special Precautions
IV route especially when cardiac status is unknown. Mild to moderate hypertension, cardiac, liver or kidney disease. In cases of breech or other abnormal presentations, do not admin inj until after baby is delivered, or in cases of multiple births until the last baby has been delivered. For postpartum haemorrhage, exclude possibility of retained placental fragments, soft tissue injury (cervical or vaginal laceration), or defects in clotting, before a further inj is given to stop bleeding.
Adverse Reactions
Nausea, vomiting, abdominal pain, headache, dizziness, rashes, hypertension, bradycardia, arrhythmias, chest pain.
Potentially Fatal: Anaphylactoid reactions.
Overdosage
Symptoms: Nausea, vomiting, hypertension or hypotension, vasospastic reactions, respiratory depression, convulsions, coma. Management: Treatment is symptomatic with respiratory and CV support.
Drug Interactions
Increased hypotensive effect of oxytocin and reduced oxytocic effect with inhalational anaesthesia e.g. cyclopropane or halothane. Increased vasopressor effects with vasoconstrictors. Potentiates effect of prostaglandins.
Potentially Fatal: Avoid concurrent use with other ergot alkaloids e.g. bromocriptine, cabergoline. Increased risk of ergot toxicity with cytochrome P450 isoenzyme CYP3A4 inhibitors e,g. protease inhibitors, macrolide antibacterials.
Action
Description: Oxytocin, a cyclic nonapeptide hormone, secreted by the hypothalamus and stored in the posterior lobe of the pituitary gland, stimulates rhythmic uterine contractions. Ergometrine, an ergot alkaloid, produces more intense and prolonged uterine contractions compared to oxytocin. Used together, they produce a rapid and sustained oxytocic action on the uterus.
Onset: Oxytocin: IV: Immediate; IM: 3-5 minutes. Ergometrine: IV: immediate; IM: 2-7 minutes.
Duration: Oxytocin: IV: Within 1 hr; IM: 2-3 hr. Ergometrine IV: 45 minutes; IM ≥3 hr.
Pharmacokinetics:
Absorption: Ergometrine: Rapidly absorbed after IM inj.
Distribution: Oxytocin: Distributed throughout the extracellular fluid with small amounts entering the foetal circulation.
Metabolism: Oxytocin: Rapidly metabolised by the liver, kidneys and oxytocinase (a circulating enzyme produced in pregnancy); plasma half-life: 3-5 minutes. Ergometrine: Undergoes hepatic metabolism.
Excretion: Oxytocin: Small amounts excreted unchanged in urine.
Storage
Store between 2-8°C. May be stored up to 25°C for 2 mth. Protect from light.
Disclaimer: This information is independently developed by MIMS based on Oxytocin + 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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