ERGOMETRINE MALEATE

Dosage form: Tablets, 0.2 mg

Uses: Ergometrine has a much more powerful action on the uterus than most of the other alkaloids of ergot, especially on the puerperal uterus. Its main action is the production of sustained contractions, in contrast to the more physiological rhythmic uterine contractions induced by oxytocin; its action is more prolonged than that of oxytocin, but less rapid in onset. Uterine stimulation is said to occur within about 10 minutes of administration by mouth, within 7 minutes of intramuscular injection, and almost immediately after intravenous administration. Following intramuscular injection of Ergometrine with oxytocin contractions are reported to occur within 2 or 3 minutes.

Administration: Ergometrine maleate is used in the prevention and treatment of postpartum haemorrhage. It is given in doses of 500 mcg, generally with oxytocin, in the UK, whereas in the US Ergometrine maleate is used alone in doses of 200 mcg. In the UK Ergometrine maleate is given with oxytocin under full obstetric supervision in the active management of the third stage of labour of normal confinements. A dose of Ergometrine maleate 500 mcg and oxytocin 5 units is injected intramuscularly after delivery of the anterior shoulder of the infant. Delivery of the placenta is actively assisted while the uterus is firmly contracted. A similar dose of Ergometrine maleate, with or without oxytocin, may be given following delivery of the placenta to prevent or treat postpartum haemorrhage; intravenous doses of 250 or 500 mcg of Ergometrine maleate have been given in emergencies. In mild secondary postpartum haemorrhage Ergometrine maleate has been given by mouth in a dose of 500 mcg three times daily. In the US Ergometrine maleate is not generally recommended before delivery of the placenta, although it has been given similarly to Ergometrine and oxytocin (above) after delivery of the anterior shoulder. More usually it is given after the third stage of labour in a dose of 200 mcg intramuscularly, repeated if necessary in 2 to 4 hours. In emergencies 200 mcg may be given intravenously. In late postpartum bleeding 200 to 400 mcg may be given twice to four times daily by mouth; it may be taken sublingually.

Observe
Adverse effects: Adverse effects reported with Ergometrine maleate, especially following intravenous administration, include headache, dizziness, tinnitus, abdominal pain, nausea, vomiting, hypertension, chest pain, palpitation, dyspnoea, and bradycardia.
Storage: Store in a cool and dry place in airtight container, away from light. Keep out of reach of children.