Classifications: adrenergic antagonist; ergot alkaloid; oxytocic; Therapeutic: ergot alkaloid; oxytocic
Pregnancy Category: C
0.2 mg tablet; 0.2 mg/mL injections
Ergot alkaloid that induces rapid, sustained tetanic uterine contraction that shortens third stage of labor and reduces
Administered after delivery of the placenta. It minimizes the risk of postpartal hemorrhage.
Routine management after delivery of placenta and for postpartum atony, subinvolution, and hemorrhage. With full obstetric
supervision, may be used during second stage of labor.
Hypersensitivity to ergot preparations; induction of labor; use prior to delivery of placenta; threatened spontaneous abortion;
prolonged use; uterine sepsis; hypertension; toxemia; angina; arteriosclerosis; CAD; dysfunctional uterine bleeding; eclampsia;
hypertension; MI; neonates; PVD; preeclampsia; Raynaud's disease; sepsis; stroke; thromboangiitis obliterans; thrombophlebitis;
pregnancy (category C).
Diabetes mellitus; hepatic disease; migraine headaches; renal failure, renal impairment; pulmonary disease; lactation.
Route & Dosage
Adult: PO 0.2 q68h x 27 d IM/IV 0.2 mg q24h (max: 5 doses)
- Note: Dosing should not exceed 1 wk.
PREPARE: Direct: Give undiluted or diluted in 5 mL of NS.
ADMINISTER: Direct: Give 0.2 mg or fraction thereof over 60 sec.
- Do not use ampules containing discolored solution or visible particles.
- Store at 15°30° C (59°86° F) unless otherwise directed. Protect from light.
Adverse Effects (≥1%)GI: Nausea, vomiting
(especially with IV
Severe hypertensive episodes, bradycardia. Body as a Whole:
Allergic phenomena including shock,
Interactions Drug: parenteral sympathomimetics
, other ergot alkaloids
add to pressor effects and carry risk of hypertension; protease inhibitors,
itraconazole may increase the risk of toxicity
Readily from GI tract. Onset:
515 min PO; 25 min IM; immediate IV
3 or more h PO; 3 h IM; 45 min IV
Distributed into breast milk. Metabolism:
Slowly in liver. Elimination:
Mainly in feces, small amount in urine. Half-Life:
Assessment & Drug Effects
- Monitor vital signs (particularly BP) and uterine response during and after parenteral administration of methylergonovine
until partum period is stabilized (about 12 h).
- Notify physician if BP suddenly increases or if there are frequent periods of uterine relaxation.
Patient & Family Education
- Report severe cramping for increased bleeding.
- Report any of the following: Cold or numb fingers or toes, nausea or vomiting, chest or muscle pain.