Generic
Methylergonovine Maleate
2 brands available in the market
At a glance
Methylergonovine Maleate is an ergot alkaloid used to control postpartum uterine bleeding and hemorrhage.
Description
Methylergonovine Maleate acts directly on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions. It induces a rapid and sustained tetanic uterotonic effect which shortens the third stage of labor and reduces blood loss.
Indications
- Management of uterine atony, hemorrhage and subinvolution of the uterus following delivery of the placenta
- Control of uterine hemorrhage in the second stage of labor following delivery of the anterior shoulder
Therapeutic class
Drugs Acting on the Uterus
Pharmacological class
Ergot Alkaloid
Pharmacology
Methylergonovine Maleate acts directly on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions.
Mechanism of action
Controls bleeding by increasing uterine contraction.
Dosage
Adult Dose:
- Intramuscular (IM): 1 mL/0.2 mg, after delivery of anterior shoulder, after delivery of placenta, or during puerperium. May repeat as required at intervals of 2-4 hours.
- Intravenous (IV): 1 mL/0.2 mg, administered slowly over no less than 60 seconds.
- Oral: 1 tablet (0.2 mg), 3-4 times daily in the puerperium for a maximum of 1 week.
Administration
- Injections administered by trained healthcare professionals
- Swallow tablet whole
- Take the dose and duration as advised by your doctor
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Hypertension (associated with seizure and/or headache)
- Hypotension
- Abdominal pain (due to uterine contractions)
- Nausea and vomiting
Rare Side Effects:
- Acute myocardial infarction
- Transient chest pains
- Vasoconstriction, vasospasm
- Coronary arterial spasm
- Bradycardia, tachycardia
- Dyspnea, hematuria
- Thrombophlebitis
- Hallucinations, leg cramps
- Diarrhea, diaphoresis
- Palpitation, rash
Precautions & warnings
- Caution in sepsis, obliterative vascular disease
- Caution during second stage of labor
- Caution if manual removal of retained placenta is required
Contraindications
- Hypertension
- Toxemia
- Pregnancy
- Hypersensitivity
Drug interactions
CYP 3A4 Inhibitors: Coadministration with macrolide antibiotics, HIV protease inhibitors, azole antifungals may cause vasospasm, cerebral ischemia or ischemia of extremities.
Food interactions
Food interaction not applicable.
Use in pregnancy
Use in Pregnancy (Category C): Contraindicated during pregnancy due to uterotonic effects.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Mothers should not breastfeed during treatment. Mothers should wait at least 12 hours after the last dose before initiating breastfeeding.
Pediatric use
Safety and effectiveness in pediatric patients have not been established.
Geriatric use
No specific dose adjustment known for elderly.
Renal / hepatic impairment
Renal Impairment: Limited information available. Caution advised.
Hepatic Impairment: Limited information available. Caution advised.
Overdose effects
Symptoms of acute overdose: nausea, vomiting, oliguria, abdominal pain, numbness of extremities, rise in blood pressure, respiratory depression, hypothermia, convulsions, coma.
Storage conditions
Store below 25°C; in tight, light-resistant container.
Chemical structure
Methylergonovine Maleate