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Indications
Active management of the third stage of labour
Treatment and prophylaxis of postpartum haemorrhage
Excessive uterine bleeding
Postpartum and post-abortion bleeding.
Treatment and prophylaxis of postpartum haemorrhage
Excessive uterine bleeding
Postpartum and post-abortion bleeding.
Pharmacology
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.
Dosage & Administration
Intramuscular (Adult)-
- Active management of the third stage of labour: 0.5 mg given with 5 units of oxytocin after delivery of the anterior shoulder of the infant or immediately after delivery.
- Treatment and prophylaxis of postpartum haemorrhage: 0.2 mg, may repeat in severe bleeding every 2-4 hr as needed.
- Excessive uterine bleeding: 0.2 mg via IV inj over at least 1 minute. May follow with oral doses of 0.2 to 0.4 mg 2-4 times daily until the danger of atony or haemorrhage has passed (usually 48 hr).
- Postpartum and post-abortion bleeding: 0.2 to 0.4 mg 2-4 times daily until danger of uterine atony and haemorrhage has passed (usually 48 hr). Max duration: 1 wk postpartum.
Interaction
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.
Contraindications
Pregnancy, 1st and 2nd stage of labour, patients with preeclampsia, eclampsia or threatened spontaneous abortion; porphyria.
Side Effects
Nausea, vomiting, abdominal pain, diarrhoea; headache, dizziness; tinnitus; chest pain, palpitation, bradycardia, transient hypertension and other cardiac arrhythmias; dyspnoea, sometimes rashes, shock
Pregnancy & Lactation
Pregnancy Category X. Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.
Precautions & Warnings
Breech and abnormal foetal presentation; hypertension; chronic anaemia; hepatic, renal, respiratory or cardiac impairment; toxemia; lactation; hypocalcaemia. Monitor BP, pulse and uterine response.
Overdose Effects
Symptoms include peripheral vasoconstriction, encephalopathy, convulsions, respiratory failure, acute renal failure and temporary lactose intolerance. Treatment is supportive.
Therapeutic Class
Drugs acting on the Uterus
Storage Conditions
Intramuscular: Refrigerate at 2-8°C. Intravenous: Refrigerate at 2-8°C. Oral: Store below 25°C.