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Brand Name :
Ergometrin
Synonyms :
Ergobasine, Ergometrina, ergometrine, Ergometrinum, Ergonovine, Ergotocine, Margonovine
Class :
Hemostatic, Oxytocic
Brand Name :
Ergometrin
Synonyms :
Ergobasine, Ergometrina, ergometrine, Ergometrinum, Ergonovine, Ergotocine, Margonovine
Class :
Hemostatic, Oxytocic
Dosage Forms & StrengthsÂ
Injectable solutionÂ
500 mg/1 mLÂ
Intramuscularly administer 200 to 500 micrograms of ergometrine following placental expulsion or when bleeding occurs;
In emergency situations, ergometrine may be administered intravenously at a dosage ranging from 250 to 500 micrograms
Dose Adjustments
N/A
Safety and efficacy are not seen in pediatricsÂ
N/AÂ
may enhance the serum concentration of Ergot Derivatives
may increase the vasoconstriction effect
may increase the vasoconstriction effect
may increase the vasoconstriction effect
may increase the vasoconstriction effect
may increase the vasoconstriction effect
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with alpha-/beta-agonists
may enhance the concentration of serum when combined with ergot derivatives
may enhance the concentration of serum when combined with ergot derivatives
may enhance the concentration of serum when combined with ergot derivatives
may enhance the concentration of serum when combined with ergot derivatives
may enhance the concentration of serum when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with alpha1-agonists
may have an increased vasoconstricting effect when combined with alpha1-agonists
bunazosin (Not available in the United States)
may have an increased vasoconstricting effect when combined with alpha1-agonists
may have an increased vasoconstricting effect when combined with alpha1-agonists
may have an increased vasoconstricting effect when combined with alpha1-agonists
may have an increasingly adverse effect when combined with bromocriptine
may have an increased vasoconstricting effect when combined with methysergide
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may enhance the concentration of serum when combined with ergot derivatives
ergot derivatives increase the effect of vasoconstriction of alpha beta agonists
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
The potential for increased CNS depression risk or seriousness occurs when ergometrine is used together with pinazepam
The potential for increased CNS depression risk or seriousness occurs when ergometrine is used together with pipecuronium
When ergometrine is used together with medazepam, the risk or seriousness of CNS depression is enhanced
The potential for CNS depression may enhanced when ergometrine is used together with fencamfamin
When ergometrine is used together with piroxicam, this leads to increased risk or seriousness of hypertension
When ergometrine is used together with oleandomycin, this leads to enhanced concentration serum of ergometrine
When ergometrine is used together with ridaforolimus, this leads to enhanced concentration serum of ergometrine
ergometrine: it may increase the risk of methemoglobinemia associated agents
ergometrine: it may increase the risk of methemoglobinemia associated agents
ergometrine: it may increase the risk of methemoglobinemia associated agents
ergometrine: it may increase the risk of methemoglobinemia associated agents
ergometrine: it may increase the risk of methemoglobinemia associated agents
may increase the serum concentration of ergot derivatives
may increase the serum concentration of ergot derivatives
may increase the serum concentration of ergot derivatives
may increase the serum concentration of ergot derivatives
may increase the serum concentration of ergot derivatives
may increase the effect of ergot derivatives
may increase the vasoconstricting effect
may increase the vasoconstricting effect
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may enhance the concentration of serum when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased vasoconstricting effect when combined with ergot derivatives
may have an increased hypertensive effect when combined with ergot derivatives
it increases the concentration of CYP3A4 substrates in the serum
it increases the concentration of CYP3A4 substrates in the serum
Actions and Spectrum:Â
Actions:Â
Ergometrine functions by directly stimulating the uterine muscle, thereby increasing both the force and frequency of contractions. This mechanism of action facilitates uterine contractions, diminishes postpartum bleeding, and serves as a preventive measure against premature birth. Additionally, ergometrine instigates contractions of the cervix. The intensified uterine contractions aid in hemostasis by contracting the uterine wall around bleeding vessels at the placental site. Notably, the drug’s oxytocic effect becomes particularly sensitive toward the end of pregnancy, rendering it effective in various obstetric scenarios. Moreover, ergometrine induces arterial vasoconstriction by stimulating alpha-adrenergic and serotonin receptors, contributing to the reduction of bleeding.Â
Spectrum:Â
Ergometrine’s spectrum involves promoting uterine contractions, preventing postpartum bleeding, and reducing excessive bleeding after delivery. It is also employed to improve uterine tone and elasticity in the postpartum period, playing a crucial role in addressing conditions related to uterine contraction and bleeding in obstetric and gynecological contexts.Â
Frequency not definedÂ
AnginaÂ
Myocardial infarctionÂ
Cardiac arrhythmiasÂ
Hypertension (transient)Â
BradycardiaÂ
Chest painÂ
PalpitationsÂ
DyspnoeaÂ
Pulmonary edemaÂ
Arterial spasmÂ
HeadacheÂ
DizzinessÂ
NauseaÂ
VomitingÂ
Abdominal painÂ
RashÂ
TinnitusÂ
VasoconstrictionÂ
Black Box Warning:Â
Ergometrine undergoes metabolism by CYP3A4. When administered in conjunction with CYP3A4 inhibitors, its adverse effects, such as vasoconstriction, may be heightened. Therefore, it is advisable to avoid combinations that include HIV protease inhibitors.
Contraindication/Caution:Â
ContraindicationsÂ
CautionsÂ
Pregnancy consideration:Â Â
Ergometrine is contraindicated during pregnancy, and its use is strictly limited to the third stage of labour .The use of any medication during pregnancy should be minimized, especially in the first trimester. Non-drug interventions should be explored as alternatives. When necessary, opt for a medication with a well-established safety profile, using the lowest effective dosage for the shortest duration. It is advisable to avoid polypharmacy.
Teratogens taken during the pre-embryonic period, typically considered until 14 to 17 days post-conception, are thought to have an all-or-nothing impact. In cases where drugs have a short half-life, and the conception date is accurately known, this may provide reassurance if drug exposure occurs within this timeframe. Â
Breastfeeding warnings:Â Â
Ergometrine is not recommended for use during breastfeeding.Â
Special consideration is needed for neonates, premature infants, those with low birth weight, and those with unstable gastrointestinal function or serious illnesses. If a drug is prescribed to a nursing mother, it should be at the lowest practical dose and for the shortest duration, especially for any infant. When drug administration is necessary, and breastfeeding is ongoing, minimizing the infant’s exposure to the drug can sometimes be achieved by timing maternal doses just after a feeding episode. Infants exposed to drugs through breast milk should be monitored for any unusual signs or symptoms. Consideration should also be given to potential interactions between the drug received by the infant from breast milk and any medication prescribed directly to the infant, particularly when the infant’s medication may affect the metabolism of the drug received through breast milk.Â
Pregnancy category:Â
Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester.Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: No data is available for the drug under this category.Â
Pharmacology:Â
It is an ergot alkaloid amine that induces direct stimulation of the smooth vascular and uterine muscles. It enhances the frequency and amplitude of contractions of uterine, elevates uterine tone, and, in turn, impedes blood flow of uterine. Moreover, it augments contractions of the cervix.Â
Pharmacodynamics:Â
Ergonovine (ergometrine) functions by directly stimulating the uterine muscle, enhancing both the frequency and force of contractions. In typical doses, these contractions precede intervals of relaxation; however, larger doses elevate tone of basal uterine and reduce these periods of relaxation. The uterine wall contraction surrounding placental site bleeding vessels promotes hemostasis. Cervical contractions triggered by ergonovine.
The uterus exhibits heightened sensitivity to the effect of oxytocin towards the end stage of pregnancy. Ergonovine’s oxytocic actions surpass its effects in vasculature. Like other alkaloids of ergot, ergonovine induces vasoconstriction which arterial by stimulating serotonin and alpha-adrenergic receptors and inhibiting the release of relaxation factors which are endothelial-derived. Ergonovine causes coronary artery vasoconstriction though it is a less potent vasoconstrictor than ergotamine, serving as a aid for diagnostic coronary vasospasm.Â
Pharmacokinetics:Â
AbsorptionÂ
Onset: Contractions of uterine typically begin 2 to 7 minutes after intramuscular administration and are after 1 minute of intravenous administration.Â
Duration: The duration of uterine contractions is at least 3 hours after intramuscular injection and approximately 45 minutes after intravenous injection.Â
Ergometrine is rapidly absorbed following intramuscular or intravenous injection.Â
DistributionÂ
It enters breast milk after passing via the placenta.Â
MetabolismÂ
In the liver, ergometrine is metabolized via hydroxylation, conjugation of glucuronic acid, and maybe N-demethylation.Â
Elimination and ExcretionÂ
It is excreted via feces.Â
Administration:Â
In the event of robust uterine contractions and to mitigate post-delivery bleeding, the standard intramuscular dosage of Ergometrine is 0.2 mg, with the option for repetition as necessary, typically every 2 to 4 hours and not exceeding a total of 5 injections. For cases of excessive uterine bleeding, the same therapeutic dose may be administered intravenously slowly over at least 1 minute, with close monitoring of blood pressure and uterine contractions.
Subsequent to the initiation of intravenous or intramuscular injections, Ergometrin tablets can be employed at a dose ranging from 0.2 to 0.4 mg every 6 to 12 hours for a period of 2 to 7 days to diminish postpartum bleeding, enhance uterine tone, and promote elasticity.Â
In the event of an overdose, symptoms may include angina pectoris, bradycardia, confusion, drowsiness, tachycardia, weakness, pupillary constriction, severe peripheral vasoconstriction (manifesting as cold, pale, or numb extremities; myalgia; cold skin), respiratory depression, convulsions, loss of consciousness, abnormal thirst, and tetany-like contractions of the uterus.
In such cases, immediate cessation of Ergometrin use is imperative. As there is no specific antagonist, treatment primarily revolves around symptomatic and supportive measures. The attending physician may recommend induced vomiting or gastric lavage (if ingestion occurred) and the administration of activated charcoal.Â
If a dose is inadvertently missed, it should be taken promptly upon recollection. However, if the next scheduled dose is imminent, the missed dose should be skipped, and the subsequent dose should be adhered to at the designated time. Doubling the prescribed dose should be avoided.Â
Patient information leafletÂ
Generic Name: ergometrineÂ
Pronounced: ur-goh-MEH-treenÂ
Why do we use ergometrine?Â
Ergometrin medication contains the primary active ingredient ergometrine along with other necessary excipients. It is a branded medication utilized to facilitate labor, control postpartum bleeding, and prevent premature birth.Â
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