No

Ergot Derivative

Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution

X

Induction of labor, threatened spontaneous abortion, hypersensitivity to ergonovine or any component

Use with caution in patients with sepsis, heart disease, hypertension, or with hepatic or renal impairment; restore uterine responsiveness in calcium-deficient patients who do not respond to ergonovine by I.V. calcium administration; avoid prolonged use; discontinue if ergotism develops

1% to 10%: Gastrointestinal: Nausea, vomiting

<1%: Palpitations, bradycardia, transient chest pain, hypertension (sometimes extreme - treat with I.V. chlorpromazine), cerebrovascular accidents, shock, myocardial infarction, ergotism, seizures, dizziness, headache, thrombophlebitis, tinnitus, dyspnea, diaphoresis

Symptoms of overdose include gangrene (chronic), seizures (acute), chest pain, numbness in extremities, weak pulse, confusion, excitement, delirium, hallucinations

Treatment is supportive following GI decontamination (for oral overdose). I.V. or intra-arterial nitroprusside for arterial venospasm; nitroglycerin for coronary vasospasm.

No data reported

Refrigerate injection, protect from light; store intact ampuls in refrigerator, stable for 60-90 days; do not use if discoloration occurs

Ergot alkaloid alpha-adrenergic agonist directly stimulates vascular smooth muscle to vasoconstrict peripheral and cerebral vessels; may also have antagonist effects on serotonin

Onset of effect: Oral: Within 5-15 minutes; I.M.: Within 2-5 minutes

Duration: Uterine effects persist for 3 hours, except when given I.V., then effects persist for ~45 minutes

Adults: I.M., I.V. (I.V. should be reserved for emergency use only): 0.2 mg, repeat dose in 2-4 hours as needed

May cause dizziness

None reported

No information available to require special precautions

No effects or complications reported

For angina diagnosis cardiologist will instruct patient about what to expect. For postpartum hemorrhage (an emergency situation) patient needs to know why the drug is being given and what side effects she might experience (eg, mild nausea and vomiting, dizziness, headache, ringing ears) and instructed to report difficulty breathing, acute headache, or numbness and cold feeling in extremities, or severe abdominal cramping. Breast-feeding precautions: Breast-feeding is not recommended.

I.V. use should be limited to patients with severe uterine bleeding or other life-threatening emergency situations

Injection, as maleate: 0.2 mg/mL (1 mL)

de Groot AN, van Dongen PW, Vree TB, et al, "Ergot Alkaloids. Current Status and Review of Clinical Pharmacology and Therapeutic Use Compared With Other Oxytocics in Obstetrics and Gynaecology," Drugs, 1998, 56(4):523-35.

Soriano D, Dulitzki M, Schiff E, et al, "A Prospective Cohort Study of Oxytoxin Plus Ergometrine Compared With Oxytocin Alone for Prevention of Postpartum Heamorrhage," Br J Obstet Gynaecol, 1996, 103(11):1068-73.