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Pronunciation: ehr-go-NO-veen MAL-ee-ate
Class: Uterine stimulant
- Tablets 0.2 mg
Increases strength, duration, and frequency of uterine contractions and decreases uterine bleeding.
Produces a firm tetanic contraction of postpartum uterus within 6 to 15 min that, in the course of about 90 min, gradually changes to a series of clonic contractions that persist for 90 min or more.
Indications and Usage
Prevention and treatment of postpartum and postabortal hemorrhage caused by uterine atony.
Oxytocin challenge test.
Induction of labor; threatened spontaneous abortion; previous allergic or idiosyncratic reactions to drug.
Dosage and AdministrationAdults
PO Immediate postpartum dose 0.2 mg. To minimize late postpartum bleeding, 0.2 to 0.4 mg 2 to 4 times daily (every 6 to 12 h) until danger of uterine atony has passed (usually 48 h).
- Administer prescribed dose by mouth or sublingually.
- Administer without regard to meals but administer with food if GI upset occurs.
Store tablets at controlled room temperature (59° to 86°F).
Drug InteractionsInhibitors of metabolism (eg, protease inhibitors [eg, ritonavir])
Increased risk of ergot toxicity (eg, peripheral vasospasm, ischemia of extremities).Sympathomimetics
Possible hypertension caused by additive vasoconstriction.
Laboratory Test Interactions
None well documented.
Increased BP (sometimes extreme).
Nausea, vomiting, cramping.
Allergy (including shock), ergotism.
Category X . Contraindicated during pregnancy.
Ergot alkaloids are excreted in breast milk.
Labor and Delivery
Because of the high uterine tone produced, ergonovine is not recommended for routine use prior to the delivery of the placenta, unless the surgeon is familiar with the technique described by Davis and others and has adequate facilities and personnel at his or her disposal.
Special Risk Patients
Use with caution in patients with hypertension, heart disease, venoatrial shunts, mitral-valve stenosis, obliterative vascular disease, sepsis, hepatic or renal function impairment.
Hypocalcemia may affect response to drug.
Avoid prolonged use and discontinue if symptoms of ergotism appear.
Closely monitor patient for signs and symptoms of ergotism (eg, intense vasoconstriction, coldness of the extremities, chest pain, gangrene). Immediately discontinue therapy and inform health care provider if noted or suspected.
Obtain baseline vital signs, with special attention to pulse and BP. Closely monitor BP during treatment. Notify health care provider immediately if BP becomes elevated. Be prepared to discontinue therapy and treat appropriately.
This is evidence of effectiveness but may justify reduction in dosage. Monitor and document uterine response during and after administration. Notify health care provider if uterine contractions are not maintained or if cramping is severe. Note character and amount of vaginal bleeding.
Hyperstimulation of uterus may lead to uterine tetany and impairment of uteroplacental blood flow, uterine rupture, cervical and perineal lacerations, amniotic fluid embolism, and trauma to infant (eg, intracranial hemorrhage).
Convulsions, gangrene, chest pain, diarrhea, dizziness, dyspnea, hypercoagulability, loss of consciousness, numbness and coldness of extremities, increase or decrease in BP, tingling, vomiting, weak pulse.
- Advise patient that medication will usually be administered by a health care professional in a medical setting.
- Advise patient to take prescribed dose either orally or sublingually as ordered.
- Caution patient not to change the dose or take for longer period than prescribed.
- Advise patient to stop taking the medication and notify health care provider immediately if any of the following occur: numbness, tingling, coldness, or paleness in the fingers or toes; muscle pain in arms or legs; weakness in the legs; chest pain, tightness, or pressure; changes in heart rate.
- Advise patient to report excessive or severe uterine cramping.
Copyright © 2009 Wolters Kluwer Health.