Dosing and uses of Ergometrine, Ergotrate (ergonovine)
Adult dosage forms and strengths
tablet
- 0.2mg
injection solution
- 0.2 mg/mL (1) mL
Pospartum or Postabortion Hemorrhage
0.2 mg IM; may repeat in 2-4hr; not to exceed 5 doses totaL
Give IV only in emergency because of potential for HTN & CVA
Alternatively, 0.2-0.4 mg PO q6-12hr PRN for 48 hr or until danger of uterine atony has passed; no more than 1 week
Give over >1 minute & monitor Bp
Other Indications & Uses
Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution
Pediatric dosage forms and strengths
Safety and efficacy not established
Ergometrine, Ergotrate (ergonovine) adverse (side) effects
Frequency not defined
Dizziness
Headache
Hypertension
Nasal congestion
Nausea and vomiting
Allergic phenomenon including shock
Angina
Arrythmia
Diaphoresis
Diarrhea
Dyspnea
Foul taste
Hallucinations
Hematuria
Hypertensive episode
Leg cramps
Thrombophlebitis
Tinnitus
Water intoxication
Warnings
Contraindications
Hypertension, toxemia, pregnancy, hypersensitivity, prolonged use
Cases of threatened spontaneous abortion
Avoid during breast-feeding
Cautions
If administered during the second or third stage of labor prior to delivery of the placenta, complications such as captivation of the placenta may occur
In patients with sepsis, hepatic impairment, renal impairment
Pregnancy and lactation
Pregnancy category: C
Lactation: excreted in milk; adverse effect on the nursing infant; may inhibit lactation; use not recommended
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Ergometrine, Ergotrate (ergonovine)
Mechanism of action
Produces vasoconstriction to increased strength, duration, and frequency of uterine contraction which in turn impedes uterine blood flow; shortens the third stage of labor
Pharmacokinetics
Half-Life: 1-5 min (initial phase); 0.5-2 hr (terminal phase)
Plasma peak time: 30 min
Concentration: 3 ng/mL
Duration in uterine effects: 3 hr (IM); 45 min (IV)
Onset: Uterine contractions are usually initiated within 5-15 min following oral administration, within 2-3 min after IM injection, and 1 min following IV injection
Metabolism: Liver
Excretion: Feces
Administration
IV Administration
Give IV only in emergency because of potential for HTN & CVA
Give over >1 min & monitor Bp
