Metherspan

• Postpartum Haemorrhage: Prevention and treatment of excessive bleeding after delivery.
• Post-abortion Bleeding: Control of bleeding after abortion.
• 3rd Stage of Labour: Aids in placental separation and expulsion.
• Uterine Bleeding: Control of excessive uterine bleeding.

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.

Adult Dose:

• Postpartum Hemorrhage (Oral): 0.2-0.4 mg PO q6-12hr for 48 hr or until danger of uterine atony has passed; max 1 week.
• Postpartum Hemorrhage (Parenteral): 0.2 mg IM; may repeat in 2-4hr; not to exceed 5 doses total.
• Emergency IV: 0.2 mg IV over >1 minute; only in emergency (due to risk of HTN & CVA).
• 3rd Stage of Labour: 0.5 mg with 5 units oxytocin IM (after delivery of anterior shoulder).

Common Side Effects:

• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
• Headache
• Dizziness
• Tinnitus
• Chest pain
• Palpitation
• Bradycardia
• Transient hypertension
• Cardiac arrhythmias
• Dyspnoea
• Rash (sometimes)
• Shock

Potentially Fatal: MI, Pulmonary oedema.

Use in Pregnancy: Category X. Fetal abnormalities demonstrated in animal or human studies. Contraindicated in pregnant women.

Precautions:

• Breech and abnormal foetal presentation
• Hypertension
• Chronic anaemia
• Hepatic, renal, respiratory or cardiac impairment
• Toxemia
• Lactation
• Hypocalcaemia
• Monitor BP, pulse and uterine response

Overdose: Symptoms include peripheral vasoconstriction, encephalopathy, convulsions, respiratory failure, acute renal failure and temporary lactose intolerance. Treatment is supportive.

Storage: IM/IV: Refrigerate at 2-8°C. Oral: Store below 25°C.