METHYLERGONOVINE (ORAL AND INJECTABLE)

(meth il er GON o veen) Brand: Methergine

What is the most significant information I must know about methylergonovine?

• You must not use methylergonovine during your pregnancy. This medicine is to be used only after delivery of your baby.

• Do not breast-feed within 12 hours after taking methylergonovine. Methylergonovine may pass into breast milk in little amounts and could affect a nursing child. In some cases, you will need to use this medicine for up to 1 week after your child is born. You may need to use a breast exhaust to establish and sustain your milk flow before your methylergonovine treatment is finished. If you use a breast exhaust during this time, throw out any milk you collect. Do not feed it to your baby.

• Search abnormal medical attention if you think you have symptoms of possible methylergonovine overdose, such as nausea, vomiting, stomach pain, numbness or tingling, muscle twitching, feeling light-headed, fainting, shallow breathing, coldness, or seizure (convulsions).

• There may be another drugs that can interact with methylergonovine. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

• Grapefruit and grapefruit juice may interact with methylergonovine and lead to unwanted side effects. Discuss the use of grapefruit commodity with your doctor.

What is methylergonovine?

• Methylergonovine is in a group of drugs called ergot alkaloids. It affects the smooth muscle of a woman's uterus, improving the muscle tone as well as the power and timing of uterine contractions.

• Methylergonovine is used just after a child is born, to help deliver the placenta (also called the "afterbirth"). It is also used to help control bleeding and to improve muscle tone in the uterus after childbirth.

• Methylergonovine may also be used for purposes than those listed in this medicine guide.

What must I discuss with my health care provider till using methylergonovine?

• You must not use this medicine if you have:

· tall blood pressure;

· toxemia of pregnancy; or

· if your child has not yet been born.

• If possible till you receive methylergonovine, speak your doctor if you have:

· liver or kidney malady; or

· risk factors for coronary artery malady (such as diabetes, menopause, smoking, being overweight, having tall blood pressure or tall cholesterol, having a family history of coronary artery disease).

• You must not use methylergonovine during your pregnancy. This medicine is to be used only after delivery of your baby.

• Do not breast-feed within 12 hours after taking methylergonovine. Methylergonovine may pass into breast milk in little amounts and could affect a nursing child. In some cases, you will need to use this medicine for up to 1 week after your child is born. You may need to use a breast exhaust to establish and sustain your milk flow before your methylergonovine treatment is finished. If you use a breast exhaust during this time, throw out any milk you collect. Do not feed it to your baby.

How must I use methylergonovine?

• Use exactly as predesigned by your doctor. Do not use in larger or less amounts or for longer than recommended. Follow the directions on your prescription label.

• Injectable methylergonovine is injected into a muscle or into a vein through an IV. You will receive this injection while you are in the delivery room and for a short time after your child is born, if needed.

• Oral methylergonovine is taken as a tablet 3 or 4 times daily for up to 1 week after your child is born. Follow your doctor's instructions.

• Methylergonovine must not be used for longer than 1 week unless your doctor has told you otherwise.

• Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

• Overdose symptoms may include vomiting, stomach pain, numbness or tingling, muscle twitching, feeling light-headed, fainting, shallow breathing, coldness, or seizure (convulsions).

What must I avoid while taking methylergonovine?

• Grapefruit and grapefruit juice may interact with methylergonovine and lead to potentially dangerous effects. Discuss the use of grapefruit commodity with your doctor.

What are the possible side effects of methylergonovine?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have a serious side effect such as:

· pain, swelling, warmth, or redness under your skin;

· seizure (convulsions);

· feeling like you might pass out;

· pounding heartbeats or fluttering in your chest;

· slow heart course, trouble breathing;

· blood in your urine;

· severe weakness, muscle cramps, confusion, slurred speech, fainting;

· hallucinations;

· chest pain or hard feeling, pain spreading to the hand or shoulder, nausea, sweating, common ill feeling;

· sudden numbness or weakness, especially on one side of the body;

· sudden severe headache, confusion, problems with vision, speech, or balance;

· pain, swelling, warmth, or redness in one or both legs; or

· dangerously tall blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

• Smaller serious side effects may include:

· nausea, mild stomach pain or vomiting, diarrhea;

· heighten sweating, mild skin rash;

· leg cramps;

· mild headache, dizziness;

· ringing in your ears;

· stuffy nose; or

· unpleasant taste in your mouth.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect methylergonovine?

• Speak your doctor about all another medicines you use, especially:

· conivaptan (Vaprisol);

· epinephrine (EpiPen, Adrenaclick, Twinject);

· imatinib (Gleevec);

· isoniazid (for treating tuberculosis);

· nefazodone;

· zileuton (Zyflo);

· an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifampin (Rifater, Rifadin, Rifamate), or telithromycin (Ketek);

· an antidepressant such as nefazodone, fluoxetine (Prozac, Rapiflux, Sarafem, Selfemra, Symbyax), or fluvoxamine (Luvox);

· antifungal medicine such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), posaconazole (Noxafil), or voriconazole (Vfend);

· cool or allergy medication that contains a decongestant (phenylephrine or pseudoephedrine);

· heart or blood pressure medicine such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), nebivolol (Bystolic), nicardipine (Cardene), propranolol (Inderal, InnoPran), quinidine (Quin-G), sotalol (Betapace), and others;

· the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek);

· HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), or saquinavir (Invirase);

· migraine headache medication such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig);

· nitrate medicine, such as nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), or isosorbide mononitrate (Imdur, ISMO, Monoket); or

· another ergot medicines such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or ergonovine (Ergotrate).

• This list is not complete and another drugs may interact with methylergonovine. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about methylergonovine.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.