methylergonovine

Generic Name: methylergonovine (oral and injectable) (meth il er GON o veen)
Brand Name: Methergine

What is methylergonovine?

Methylergonovine is in a group of drugs called ergot alkaloids. It affects the smooth muscle of a woman's uterus, improving the muscle tone as well as the strength and timing of uterine contractions.

Methylergonovine is used just after a baby is born, to help deliver the placenta (also called the "afterbirth"). It is also used to help control bleeding and to improve muscle tone in the uterus after childbirth.

Methylergonovine may also be used for purposes than those listed in this medication guide.

What is the most important information I should know about methylergonovine?

You should not use methylergonovine during your pregnancy. This medication is to be used only after delivery of your baby.

Do not breast-feed within 12 hours after taking methylergonovine. Methylergonovine may pass into breast milk in small amounts and could affect a nursing baby. In some cases, you will need to use this medication for up to 1 week after your baby is born. You may need to use a breast pump to establish and maintain your milk flow until your methylergonovine treatment is finished. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby.

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Seek emergency medical attention if you think you have symptoms of possible methylergonovine overdose, such as nausea, vomiting, stomach pain, numbness or tingling, muscle twitching, feeling light-headed, fainting, shallow breathing, coldness, or seizure (convulsions).

There may be other drugs that can interact with methylergonovine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Grapefruit and grapefruit juice may interact with methylergonovine and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

What should I discuss with my health care provider before using methylergonovine?

You should not use this medication if you have:

  • high blood pressure;

  • toxemia of pregnancy; or

  • if your baby has not yet been born.

If possible before you receive methylergonovine, tell your doctor if you have:

  • liver or kidney disease; or

  • risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease).

You should not use methylergonovine during your pregnancy. This medication is to be used only after delivery of your baby.

Do not breast-feed within 12 hours after taking methylergonovine. Methylergonovine may pass into breast milk in small amounts and could affect a nursing baby. In some cases, you will need to use this medication for up to 1 week after your baby is born. You may need to use a breast pump to establish and maintain your milk flow until your methylergonovine treatment is finished. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby.

How should I use methylergonovine?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Injectable methylergonovine is injected into a muscle or into a vein through an IV. You will receive this injection while you are in the delivery room and for a short time after your baby is born, if needed.

Oral methylergonovine is taken as a tablet 3 or 4 times daily for up to 1 week after your baby is born. Follow your doctor's instructions.

Methylergonovine should not be used for longer than 1 week unless your doctor has told you otherwise.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include vomiting, stomach pain, numbness or tingling, muscle twitching, feeling light-headed, fainting, shallow breathing, coldness, or seizure (convulsions).

What should I avoid while taking methylergonovine?

Grapefruit and grapefruit juice may interact with methylergonovine and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Methylergonovine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • pain, swelling, warmth, or redness under your skin;

  • seizure (convulsions);

  • feeling like you might pass out;

  • pounding heartbeats or fluttering in your chest;

  • slow heart rate, trouble breathing;

  • blood in your urine;

  • severe weakness, muscle cramps, confusion, slurred speech, fainting;

  • hallucinations;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden severe headache, confusion, problems with vision, speech, or balance;

  • pain, swelling, warmth, or redness in one or both legs; or

  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

  • nausea, mild stomach pain or vomiting, diarrhea;

  • increased sweating, mild skin rash;

  • leg cramps;

  • mild headache, dizziness;

  • ringing in your ears;

  • stuffy nose; or

  • unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Methylergonovine dosing information

Usual Adult Dose for Postpartum Bleeding:

For the prevention and control of postpartum hemorrhage:

0.2 mg intramuscularly or intravenously (see precautions) after delivery of the anterior shoulder, after delivery of the placenta, or during the puerperium. May be repeated as required, at intervals of 2 to 4 hours.

0.2 mg orally 3 or 4 times daily in the puerperium for a maximum of 1 week.

What other drugs will affect methylergonovine?

Tell your doctor about all other medicines you use, especially:

  • conivaptan (Vaprisol);

  • epinephrine (EpiPen, Adrenaclick, Twinject);

  • imatinib (Gleevec);

  • isoniazid (for treating tuberculosis);

  • nefazodone;

  • zileuton (Zyflo);

  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifampin (Rifater, Rifadin, Rifamate), or telithromycin (Ketek);

  • an antidepressant such as nefazodone, fluoxetine (Prozac, Rapiflux, Sarafem, Selfemra, Symbyax), or fluvoxamine (Luvox);

  • antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), posaconazole (Noxafil), or voriconazole (Vfend);

  • cold or allergy medicine that contains a decongestant (phenylephrine or pseudoephedrine);

  • heart or blood pressure medication such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), nebivolol (Bystolic), nicardipine (Cardene), propranolol (Inderal, InnoPran), quinidine (Quin-G), sotalol (Betapace), and others;

  • the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek);

  • HIV/AIDS medication such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), or saquinavir (Invirase);

  • migraine headache medicine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig);

  • nitrate medication, such as nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), or isosorbide mononitrate (Imdur, ISMO, Monoket); or

  • other ergot medicines such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or ergonovine (Ergotrate).

This list is not complete and other drugs may interact with methylergonovine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about methylergonovine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.02. Revision Date: 2012-08-17, 11:36:09 AM.

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