Generic Name and Formulations:
Methylergonovine maleate 0.2mg/mL; amp.
Following delivery of the placenta, for routine management of uterine atony, hemorrhage, and subinvolution of the uterus. For control of uterine hemorrhage in the second stage of labor following delivery of the anterior shoulder.
IM: 0.2mg after delivery of the anterior shoulder, after delivery of the placenta, or during the puerperium; may be repeated as required at intervals of 2–4 hours. IV: 0.2mg given slowly over a period of no less than 60 seconds.
Hypertension. Toxemia. Pregnancy (Cat.C).
Avoid intra-arterial, periarterial injection. Coronary artery disease or risk factors; may be more susceptible to developing MI and infarction associated with methylergonovine-induced vasospasm. Sepsis. Obliterative vascular disease. Hepatic or renal disease. 2nd stage of labor. Nursing mothers: not recommended (wait at least 12hrs after last dose before initiating or resuming feeding).
Potentiated by vasoconstrictors, other ergot alkaloids, prostaglandins, beta-blockers. Potent CYP3A4 inhibitors (eg, macrolides, protease inhibitors, reverse transcriptase inhibitors, azole antifungals): not recommended. Use caution with less potent CYP3A4 inhibitors (eg, saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxamine, zileuton, clotrimazole). Antagonized by strong inducers of CYP3A4 (eg, nevirapine, rifampicin), anesthetics (eg, halothane, methoxyflurane). Antagonizes glyceryl trinitrate, other antianginal drugs.
Hypertension associated with seizure and/or headache, hypotension, abdominal pain, GI upset; rare: cardiovascular effects (eg, vasoconstriction, acute MI, transient chest pains).
Tabs—100; Inj (1mL amps)—20