Ergometrine (Maleate)

Ergometrine (Maleate) is a derivative of ergot (fungus). It produces contraction of uterine muscle and used after delivery of baby to prevent or reduce maternal hemorrhage.

Ergometrine (Maleate) is primarily indicated in conditions like Bleeding caused by uterine atony, Migraine, Post abortion hemorrhage, Postpartum hemorrhage, Prevention and treatment of hemorrhage due to incomplete abortion, Routine management of the 3rd stage of labor, Uterine subinvolution, and can also be given in adjunctive therapy as an alternative drug of choice in Uterine atony.

Ergometrine (Maleate) is contraindicated in conditions like Hypertension in pregnancy, Renal diseases, Liver diseases, Labor induction, Heart disease, Threatened spontaneous abortion, Arteriovenous shunt.

The severe or irreversible adverse effects of Ergometrine (Maleate), which give rise to further complications include Vascular complications, Ischemia, Gangrene. Ergometrine (Maleate) produces potentially life-threatening effects which include Coma, Seizures, Nausea, Vomiting, Hypertension, Hypotension, Diarrhea, Cold extremities, Severe thirst, Confusion, which are responsible for the discontinuation of Ergometrine (Maleate) therapy. The signs and symptoms that are produced after the acute over dosage of Ergometrine (Maleate) include Nausea, Vomiting, Seizures, Angina, Confusion, Unconsciousness, Palpitations, Dizziness, Hypertension, Gangrene, Dyspnea, Vasoconstriction of the extremities. The symptomatic adverse reactions produced by Ergometrine (Maleate) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Nausea, Vomiting, Palpitation, Tinnitus, Abdominal pain, Vertigo, Chest pain, Angina, Shortening of breath, Pulmonary edema.

Ergometrine should not be used for the induction of labor or during the first stage of labor. Its use should be avoided in patients with eclampsia. In case of any kind of infection or illness check with your doctor before taking Ergonovine since sensitivity to ergonovine's effects may increase. It should be used with caution in patient with impaired pulmonary function, sepsis, renal or hepatic disease and in patients with porphyria. Patient should be advised not to drive or use machines while receiving ergonovine. In case of any kind of infection or illness check with your doctor before taking Ergonovine since sensitivity to ergonovine's effects may increase.

Drug should not be given to Pediatrics, Pregnant Mothers, Cardiac / Hypertensive Patients, Geriatrics, and Neonates. If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

200 mcg (200 (200)) 4 hourly IM — This amount is given in emergencies such as uterine bleeding. Frequency may be increased from 2 to 4 hourly as needed, for maximum 5 doses. Or Single dose of 250 to 500 mcg can also be given. 200 to 400 mcg (300 (300)) 6 hourly PO — For parental treatment of haemorrhage. The dose can be given for upto 7 days, untill the danger of atony or haemorrhage has passed. Ergonovine should be swallowed or placed under tongue. 500 mcg (500 (500)) 8 hourly PO — For the treatment of mild secondary postmartum haemorrhage. The dose can be given for 2 to 7 days.

( ) — Not recommended in this age group

( ) — Not recommended in this age group

Ergometrine (Maleate) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAdrenalineCoadministration increases blood pressure by vasoconstriction due to alpha adrenergic agonist activity of ergot alkaloids.ModerateCoadministration is not recommended. If use then close clinical monitoring of response, tolerance and excessive vasoconstriction is recommended.EphedrineBoth agents acts additively and synergistically to produce vasoconstriction results in increased blood pressure.ModerateConcomitant use is considered contraindicated. Closely monitor for response and tolerance of patient. ErythromycinCoadministration increases concentration of ergotamine in the plasma causing untoward peripheral vasoconstrictionModerateCoadministration is not recommended. If use then close clinical monitoring of response, tolerance and excessive vasoconstriction is recommended.HalothaneHalothane decreases the oxytcic effects of ergonovine.MinorClosely monitor for change in efficacy during coadministration.Ketamine (HCl)MifepristoneOral contraceptive increase platelet aggregability and promote thrombus formationModeratesimultaneous use of ergometrine with oral contraceptives should be avoidedOxprenolol (HCl)simultaneous use of ergometrine and b- adrenoceptor blocker may increase peripheral vascular resistance. increase risk of vascular occlusion . simultaneous use of ergometrine and b- adrenoceptor blocker should be avoidedOxytocin These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Tab, Inj Store in a well closed container. Refrigeration is recommended. Protect from Sunlight.