Ergometrine

Indications
 Oral
Prophylaxis of postpartum haemorrhage
Adult: 200 mcg 3-4 times daily in the puerperium for 2-7 days.
Intramuscular
Treatment and prophylaxis of postpartum and postabortal haemorrhage
Adult: 200 mcg. May repeat every 2-4 hr. Max: 5 doses.
Intravenous
Treatment and prophylaxis of postpartum and postabortal haemorrhage
Adult: As an emergency measure: 200 mcg by slow inj over at least 1 minute, may repeat every 2-4 hr, up to a max of 5 doses.
Contraindications
 Hypertension, eclamptic or previously hypertensive patients, heart disease, venoatrial shunts, mitral valve stenosis, obliterative vascular disease. Do not use in cases of threatened spontaneous abortion. Pregnancy.
Warnings / Precautions
 Captivation of the placenta may occur if given during the 2nd or 3rd stage of labour prior to delivery of the placenta; use in this situation should only be done by a qualified personnel. Avoid prolonged use. Caution in patients with sepsis, hepatic or renal impairment. Lactation.
Adverse Reactions
 Headache, dizziness, hallucinations; tinnitus; nausea, vomiting, foul taste, diarrhoea; hypertension, temporary chest pain, palpitations, bradycardia; nasal congestion, dyspnoea; diaphoresis; thrombophlebitis; haematuria; water intoxication; leg cramps; allergic reactions.
Potentially Fatal: Shock.
Overdose Reactions
 Symptoms: Prolonged gangrene, numbness in extremities, acute nausea, vomiting, abdominal pain, respiratory depression, changes in BP, seizures. Management: Symptomatic and supportive.
Drug Interactions
 Possible increase in serum levels and risk of severe vasoconstrictive effects with potent CYP3A4 inhibitors (e.g. erythromycin, troleandomycin, clarithromycin, ritonavir, indinavir, nelfinavir, delavirdine, ketoconazole, itraconazole, voriconazole) and less potent CYP3A4 inhibitors (e.g. saquinavir, nefazodone, fluconazole, fluoxetine, fluvoxamine, zileuton, clotrimazole).
See Below for More methylergometrine Drug Interactions
Food Interactions
 Possible increase in serum levels and risk of severe vasoconstrictive effects with grapefruit juice.
Mechanism of Actions
 Methylergometrine is an ergot alkaloid, which directly stimulates contractions of uterine and vascular smooth muscle.
Onset: 5-15 min (oral); 2-5 min (IM); immediate (IV).
Duration: ≥3 hr (oral/IM); 45 min (IV).
Absorption: Rapidly absorbed (oral; IM).
Distribution: Mainly distributed into plasma and extracellular fluid; rapidly distributed into tissues. Enters the breast milk.
Metabolism: Hepatic: Undergoes first-pass metabolism.
Excretion: Mainly via faeces; via urine (small amounts as unchanged drug); 2-3 hr (elimination half-life).
Storage Conditions
 Intramuscular: Store under refrigeration at 2-8°C (36-46°F). Protect from light. Intravenous: Store under refrigeration at 2-8°C (36-46°F). Protect from light. Oral: Store below 25°C (77°F).
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.
Storage
 Intramuscular: Store under refrigeration at 2-8°C (36-46°F). Protect from light. Intravenous: Store under refrigeration at 2-8°C (36-46°F). Protect from light. Oral: Store below 25°C (77°F).
Available As
  • Methylergometrine 0.125 mcg
  • Methylergometrine 0.125 mg
  • Ergometrine 0.125 mg
  • Methylergometrine 0.2 mg
  • Ergometrine 0.2 mg
  • Ergometrine Tartrate 0.3 mg
  • Ergometrine 0.5 mg
  • Ergometrine Tartrate 1 mg
  • Ergometrine 1 mg
  • Ergometrine 50 mg

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