Methylergonovine, Ergonovine

Class: Oxytocics
ATC Class: G02AB03
VA Class: GU600
CAS Number: 57432-61-8
Brands: Ergotrate, Methergine

Introduction

Stimulates contractions of uterine smooth muscle; amine ergot alkaloids.

Uses for Methylergonovine, Ergonovine

Postpartum Hemorrhage

Prevention and treatment of postpartum hemorrhage in the presence of uterine atony.

Administration of parenteral ergot alkaloids in the third stage of labor decreases mean blood loss and incidence of postpartum blood loss of ≥500 mL.

Methylergonovine maleate: A first-line agent for the treatment of postpartum hemorrhage; usually given after oxytocin.

Should not be used for the induction or augmentation of labor. Should not be used in cases of threatened spontaneous abortion.

Test for Variant Angina

Ergonovine maleate: Has been useful in diagnosing variant angina†. Administered IV to induce coronary artery spasm in patients with suspected variant angina.

Methylergonovine, Ergonovine Dosage and Administration

Administration

Ergonovine maleate: Administer orally or by IM injection. When used for diagnosis of variant angina†, has been administered IV.

Methylergonovine maleate: Administer orally or by IM or slow IV injection. Parenteral preparation also has been administered directly into the uterine corpus†.

Do not administer by intra-arterial or periarterial injection.

IV Administration

Methylergonovine maleate: For drug compatibility information, see Compatibility under Stability.

Methylergonovine maleate: Reserve IV administration for severe uterine bleeding or other life-threatening emergency situations. (See IV Administration under Cautions.)

If given IV, monitor BP.

Dilution

Methylergonovine maleate: May be diluted to a volume of 5 mL with 0.9% sodium chloride injection.

Rate of Administration

Methylergonovine maleate: Administer over at least 1 minute.

Dosage

Available as ergonovine maleate; dosage expressed in terms of ergonovine maleate.

Available as methylergonovine maleate; dosage expressed in terms of methylergonovine maleate.

Adults

Postpartum Hemorrhage

Oral or Sublingual

Ergonovine maleate: To minimize late postpartum bleeding, 0.2–0.4 mg every 6–12 hours until uterine atony has passed (usually 48 hours). Lower dose may be used if severe cramping occurs.

Oral

Methylergonovine maleate: To control uterine bleeding during the puerperium, 0.2 mg 3 or 4 times daily for up to 1 week.

IM

Ergonovine maleate: 0.2 mg. Repeat as necessary; manufacturer states that IM dose rarely needed more frequently than once in 2–4 hours.

IV or IM

Methylergonovine maleate: 0.2 mg; repeat as necessary every 2–4 hours.

Test for Variant Angina†

IV

Ergonovine maleate: 0.1–0.4 mg has been used.

Special Populations

Hepatic Impairment

No specific dosage recommendations for hepatic impairment.

Renal Impairment

No specific dosage recommendations for renal impairment.

Geriatric Patients

Methylergonovine maleate: Manufacturer recommends selecting dose with caution; start at the lower end of the dosing range due to the greater frequency of decreased hepati...