Actions and Spectrum: 

ergonovine is a medication that is used for a variety of purposes, including treating certain types of headaches, preventing bleeding after childbirth, and stimulating uterine contractions during labor. It is a type of ergot alkaloid, which means that it is derived from the ergot fungus. 

The primary action of ergonovine is to stimulate the smooth muscle tissue in the body, including the smooth muscle in the blood vessels and uterus. It works by binding to and activating specific receptors in these tissues, which leads to their contraction. 

In the blood vessels, ergonovine causes vasoconstriction, which means that the blood vessels narrow and the blood flow through them is reduced.  

In the uterus, ergonovine can cause strong, coordinated contractions, which can be useful during labor to help promote the progress of childbirth. It can also be used after childbirth to help prevent excessive bleeding by causing the uterus to contract. 

DRUG INTERACTION

Contraindicated  

Serious Use Alternative  

Monitor Closely  

Minor  

Frequency not Defined 

Peripheral vasospasm 

Gangrene 

Palpitation 

Vasoconstriction 

Bradycardia 

Thrombophlebitis 

Ventricular arrhythmias 

Chest pain 

Diarrhea 

Vomiting 

Nausea 

Abdominal Pain 

Esophageal spasm 

Hypertension 

Headache 

Dizziness 

Skin rashes 

Diaphoresis 

Dyspnea 

Pleural thickening 

Leg cramps 

Hallucinations 

Abnormal liver functioning 

Black Box Warning: 

The black box warning for ergonovine states that the medication should not be used to induce labor in women with a history of cardiovascular disease, including hypertension, preeclampsia, and eclampsia.

This is because ergonovine can cause constriction of the blood vessels, that leads to decrease in blood flow causing a heart attack, stroke, and death. 

Contraindication/Caution: 

Contraindications: 

• History of cardiovascular disease, including hypertension, preeclampsia, and eclampsia 
• Hypersensitivity to ergot alkaloids 
• Active thrombophlebitis, arterial disease, or severe liver or kidney disease 
• Acute porphyria 

Caution: 

• Use in patients with a history of asthma, sepsis, or metabolic acidosis 
• Use in patients with a history of migraine headaches 
• Use in patients with a history of coronary artery disease, angina, or other cardiovascular risk factors 
• Use in patients who are taking medications that can interact with ergonovine, such as beta-blockers or certain antibiotics 

Pregnancy consideration:  

Category X 

Breastfeeding warnings:  

Lactating mothers should not breastfeed during the therapy 

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: No evidence of risk to the fetus is found in animal reproduction studies, and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a human product; Pregnant women must take care of the potential risks. 
• Category D: There is adequate data with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergencies for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. The drug is not for pregnant women. 
• Category N: No data is available for the drug under this category. 

Pharmacology: 

ergonovine works by binding to and activating specific receptors in smooth muscle cells, leading to their contraction. It has a high affinity for the serotonin receptor subtype 5-HT2A, as well as for alpha-adrenergic receptors. The activation of these receptors causes vasoconstriction, leading to decreased blood flow through the vessels. In the uterus, ergonovine causes strong, coordinated contractions, leading to its use during labor to help promote the progress of childbirth. 

Pharmacodynamics: 

Effect on Uterine Contraction: ergonovine has a direct stimulatory effect on the smooth muscle of the uterus, causing strong and coordinated contractions. The medication increases the tone and frequency of uterine contractions, leading to the progress of labor. It is particularly useful in cases of postpartum hemorrhage, where it can help to prevent excessive bleeding by promoting uterine contractions. 

Effect on Blood Vessels: ergonovine causes vasoconstriction by activating alpha-adrenergic receptors and 5-HT2A receptors in the smooth muscle cells of the blood vessels. This can lead to decreased blood flow through the vessels, which can be useful in the treatment of certain types of headaches, such as migraines. However, excessive vasoconstriction can also lead to serious complications such as heart attack, stroke, and tissue damage. 

Pharmacokinetics: 

Absorption 

ergonovine is administered orally, intravenously, or intramuscularly. After oral administration, ergonovine is rapidly and completely absorbed from the gastrointestinal tract. Peak plasma concentrations are reached within 30 minutes to 2 hours after oral administration. 

Distribution 

ergonovine is widely distributed throughout the body, with a volume of distribution of about 1.5 L/kg. It is highly bound to plasma proteins, with a protein binding of more than 90%. 

Metabolism 

ergonovine is primarily metabolized in the liver by cytochrome P450 enzymes, particularly CYP3A4. The major metabolite of ergonovine is 6-methylergometrine, which is less active than the parent drug. 

Elimination 

ergonovine and its metabolites are excreted mainly in the urine, with a half-life of about 2 hours. The clearance of ergonovine is reduced in patients with liver disease. 

Administration: 

ergonovine is usually administered as an oral tablet, an injection, or an intrauterine device. The dosage and route of administration depend on the condition being treated and the response of the patient to the medication. 

Patient information leaflet 

Generic Name: ergonovine 

Pronounced: er-goe-NOE-veen 

Why do we use ergonovine? 

ergonovine is used for several medical purposes, including the prevention and treatment of excessive bleeding after childbirth and the treatment of migraines. Here are some of the reasons why ergonovine is used: 

• Prevention and treatment of postpartum bleeding: ergonovine is used to prevent and treat excessive bleeding after childbirth. It contracts the uterus, which helps to control bleeding. 
• Treatment of migraines: ergonovine can be used to treat migraines, particularly those that are associated with menstrual cycles. It constricts the blood vessels in the brain, which helps to reduce the severity and duration of migraines. 
• Diagnostic purposes: ergonovine may be used for diagnostic purposes, such as to test the blood flow in the heart or to help diagnose certain types of tumors. 
• Uterine stimulant: ergonovine can also be used as a uterine stimulant in certain medical procedures, such as during a dilation and curettage (D&C) procedure.