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ERGONOVINE/METHYLERGONOVINE (Systemic)

Some commonly used brand names are:

In the U.S.—

  • Ergotrate 1
  • Methergine 2

In Canada—

  • Ergotrate Maleate 1

Other commonly used names are:

Ergometrine

Methylergometrine

Note:

For quick reference, the following medicines are numbered to match the corresponding brand names.

This information applies to the following medicines
1. Ergonovine (er-goe-NOE-veen)§
2. Methylergonovine (meth-ill-er-goe-NOE-veen)
† Not commercially available in Canada
§ Generic name product may be available in Canada

Category

  • Diagnostic aid, coronary vasospasm— Ergonovine
  • Uterine stimulant—Ergonovine; Methylergonovine

Description

Ergonovine and methylergonovine belong to the group of medicines known as ergot alkaloids. These medicines are usually given to stop excessive bleeding that sometimes occurs after abortion or a baby is delivered. They work by causing the muscle of the uterus to contract.

Ergonovine and methylergonovine may also be used for other conditions as determined by your doctor.

These medicines are available only on prescription and are to be administered only by or under the supervision of your doctor. They are available in the following dosage forms:

  • Oral
  • Ergonovine
    • Tablets (U.S. and Canada)
  • Methylergonovine
    • Tablets (U.S.)
  • Parenteral
  • Ergonovine
    • Injection (U.S. and Canada)
  • Methylergonovine
    • Injection (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ergonovine and methylergonovine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to ergonovine, methylergonovine, or other ergot medicines. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Breast-feeding—This medicine passes into the breast milk and may cause unwanted effects, such as vomiting; decreased circulation in the hands, lower legs, and feet; diarrhea; weak pulse; unstable blood pressure; or convulsions (seizures) in infants of mothers taking large doses.

Children—Although there is no specific information comparing use of ergonovine or methylergonovine in children with use in other age groups, these medicines are not expected to cause different problems in children than they do in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of ergonovine or methylergonovine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ergonovine or methylergonovine it is especially important that your health care professional know if you are taking any of the following:

  • Bromocriptine (e.g., Parlodel) or
  • Other ergot alkaloids (dihydroergotamine [e.g., D.H.E. 45], ergoloid mesylates [e.g., Hydergine], ergotamine [e.g., Gynergen], methysergide [e.g., Sansert])—Use of these medicines with ergonovine or methylergonovine may increase the chance of side effects of these medicines.
  • Nitrates or
  • Other medicines for angina—Use of these medicines with ergonovine or methylergonovine may keep these medicines from working properly

Other medical problems—The presence of other medical problems may affect the use of ergonovine or methylergonovine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angina (chest pain) or other heart problems or
  • Blood vessel disease or
  • High blood pressure (or history of) or
  • Stroke (history of)—These medicines may cause changes in how the heart works or blood pressure changes
  • Infection—Infections may cause an increased sensitivity to the effect of these medicines
  • Kidney disease
  • Liver disease—The body may not remove these medicines from the bloodstream at the usual rate, which may make the medicine work longer or increase the chance for side effects
  • Raynaud's phenomenon—Use of these medicines may cause worsening of the blood vessel narrowing that occurs with this disease

Proper Use of This Medicine

Take this medicine only as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much is taken or if it is taken for a longer time than your doctor ordered, it may cause serious effects.

Dosing—The dose of ergonovine or methylergonovine will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of ergonovine and methylergonovine. If your dose is different, do not change it unless your doctor tells you to do so.

  • For ergonovine
  • For oral dosage forms (tablets):
    • For treatment of excessive uterine bleeding:
      • Adults—0.2 to 0.4 milligram, swallowed or placed under the tongue every six to twelve hours. Usually this medicine is taken for forty-eight hours or less.
  • For injection dosage form:
    • For treatment of excessive uterine bleeding:
      • Adults—0.2 milligram, injected into a muscle or vein. This dose can be repeated up to five times if needed, with a two- to four-hour wait between doses.
  • For methylergonovine
  • For oral dosage forms (tablets):
    • For treatment of excessive uterine bleeding:
      • Adults—0.2 to 0.4 milligram, taken every six to twelve hours. Usually this medicine is taken for forty-eight hours or less.
  • For injection dosage form:
    • For treatment of excessive uterine bleeding:
      • Adults—0.2 milligram, injected into a muscle or vein. This dose can be repeated up to five times if needed, with a two- to four-hour wait between doses.

Missed dose—If you miss a dose of this medicine, do not take the missed dose at all and do not double the next one. Instead, go back to your regular dosing schedule. If you have any questions about this, check with your doctor.

Storage—To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If you have an infection or illness of any kind, check with your doctor before taking this medicine, since you may be more sensitive to its effects.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with the health care professional immediately if any of the following side effects occur:

Less common

Chest pain

Rare

Blurred vision; convulsions (seizures); crushing chest pain; headache (sudden and severe); irregular heartbeat; unexplained shortness of breath

Check with your doctor as soon as possible if any of the following side effects occur:

Less common

Slow heartbeat

Rare

Itching of skin; pain in arms, legs, or lower back; pale or cold hands or feet; weakness in legs

Symptoms of overdose

Bluish color of skin or inside of nose or mouth; chest pain; cool, pale, or numb arms or legs; confusion; cramping of the uterus (severe); decreased breathing rate; drowsiness; heartbeat changes; muscle pain; small pupils; tingling, itching, and cool skin; trouble in breathing; unconsciousness; unusual thirst; weak or absent pulse in arms or legs; weak pulse

With long-term use

Dry, shriveled-looking skin on hands, lower legs, or feet; false feeling of insects crawling on the skin; pain and redness in an arm or leg; paralysis of one side of the body

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common

Cramping of the uterus; nausea; vomiting

Less common

Abdominal or stomach pain; diarrhea; dizziness; headache (mild and temporary); ringing in the ears; stuffy nose; sweating; unpleasant taste

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 06/07/1993

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