Methylergometrine Injectable: Dosing and Precautions

Therapeutic action

Uterotonic, oxytocic.

Indications

Postpartum haemorrhage due to uterine atony, although oxytocin is preferred for this indication.

Forms and strengths, route of administration

• 0.2 mg in 1 ml ampoule (0.2 mg/ml) for IM injection.

Dose

• Adult: 0.2 mg every 2 to 4 hours if necessary, maximum 1 g.

Contra-indications, adverse effects, precautions

• Do not administer during delivery or labour.
• Do not administer in case of allergy to ergot alkaloids, severe hypertension, pre-eclampsia, eclampsia, or septicaemia.
• Do not combine with another ergot alkaloid.
• Administer with caution to patients with hepatic or renal impairment or ischaemic disorders.
• Do not administer simultaneously with prostaglandins or oxytocin because uterotonic activity is additive.
• May cause gastrointestinal disturbances, headache, paraesthesia, confusion, dizziness, tinnitus, hypertension, peripheral vasoconstriction, and chest pain.
• Monitor combination with metronidazole, azole antifungals, macrolides, protease inhibitors, efavirenz, and fluoxetine due to the risk of ergotism.
• Pregnancy: contraindicated.
• Breast-feeding: avoid.
• Do not confuse with dihydroergotamine, another ergot alkaloid used for different indications.
• Ergometrine is another uterotonic used for the same indications.