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Pronunciation |
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(meth
il er goe NOE
veen) |
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U.S. Brand
Names |
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Methergine® |
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Generic
Available |
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No |
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Synonyms |
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Methylergometrine Maleate; Methylergonovine Maleate |
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Pharmacological Index |
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Ergot Derivative |
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Use |
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Prevention and treatment of postpartum and postabortion hemorrhage caused by
uterine atony or subinvolution |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Induction of labor, threatened spontaneous abortion, hypertension, toxemia,
hypersensitivity to methylergonovine or any component,
pregnancy |
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Warnings/Precautions |
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Use caution in patients with sepsis, obliterative vascular disease, hepatic,
or renal involvement, hypertension; administer with extreme caution if using
I.V. |
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Adverse
Reactions |
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>10%: Cardiovascular: Hypertension
1% to 10%: Gastrointestinal: Nausea, vomiting
<1%: Temporary chest pain, palpitations, hallucinations, dizziness,
seizures, headache, water intoxication, diarrhea, thrombophlebitis, leg cramps,
tinnitus, hematuria, dyspnea, nasal congestion, diaphoresis, foul taste
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Overdosage/Toxicology |
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Symptoms include vasospastic effects, nausea, vomiting, lassitude, impaired
mental function, hypotension, hypertension, unconsciousness, seizures, shock,
and death
Treatment includes general supportive therapy, gastric lavage, or induction
of emesis, activated charcoal, saline cathartic; keep extremities warm.
Activated charcoal is effective at binding certain chemicals, and this is
especially true for ergot alkaloids; treatment is symptomatic with heparin,
vasodilators (nitroprusside); vasodilators should be used with caution to avoid
exaggerating any pre-existing hypotension. |
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Drug
Interactions |
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Augmented effects may occur with concurrent use of methylergonovine and
vasoconstrictors or ergot alkaloids |
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Stability |
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Ampuls must be protected from light and stored at temperatures
25°C (<77°F) |
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Mechanism of
Action |
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Similar smooth muscle actions as seen with ergotamine; however, it affects
primarily uterine smooth muscles producing sustained contractions and thereby
shortens the third stage of labor |
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Pharmacodynamics/Kinetics |
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Onset of oxytocic effect: Oral: 5-10 minutes; I.M.: 2-5 minutes; I.V.:
Immediately
Duration of action: Oral: ~3 hours; I.M.: ~3 hours; I.V.: 45 minutes
Absorption: Rapid
Distribution: Rapidly distributed primarily to plasma and extracellular fluid
following I.V. administration; distribution to tissues also occurs rapidly
Metabolism: In the liver
Half-life (biphasic): Initial: 1-5 minutes; Terminal: 30 minutes to 2 hours
Time to peak serum concentration: Within 30 minutes to 3 hours
Elimination: In urine and feces |
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Usual Dosage |
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Adults:
I.M.: 0.2 mg after delivery of anterior shoulder, after delivery of placenta,
or during puerperium; may be repeated as required at intervals of 2-4 hours
I.V.: Same dose as I.M., but should not be routinely administered I.V.
because of possibility of inducing sudden hypertension and cerebrovascular
accident |
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Mental Health: Effects
on Mental Status |
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May rarely cause dizziness or hallucinations |
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Mental Health:
Effects on Psychiatric
Treatment |
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None reported |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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This drug will generally not be needed for more than a week. You may
experience nausea and vomiting (small frequent meals may help), dizziness,
headache, or ringing in the ears (will reverse when drug is discontinued).
Report any respiratory difficulty, acute headache, or numb cold extremities, or
severe abdominal cramping. Breast-feeding precautions: Breast-feeding is
not recommended. |
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Nursing
Implications |
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Ampuls containing discolored solution should not be used |
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Dosage Forms |
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Injection, as maleate: 0.2 mg/mL (1 mL)
Tablet, as maleate: 0.2 mg |
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References |
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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. |
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