Methylergonovine
METHERGINE
Pronunciation: meth-il-er-goe-NOE-veen
What it isErgot alpha-adrenergic agonist causing sustained uterine contraction; postpartum hemorrhage.
Why this oneIt works after oxytocin failure through a sustained rather than rhythmic uterine contraction.
What limits it⚑ Contraindicated in hypertension and preeclampsia because pressure can rise sharply. Coronary vasospasm; avoid CYP3A4 inhibitors.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Puerperium (postpartum uterine bleeding) | Adults | 0.2 mg TID–QID | 0.2 mg QID; max 1 week |
Renal Undefined
Hepatic Undefined
Instructions
- Oral administration
- Maximum duration of therapy: 1 week
Available strengths
- tab 0.2 mg
- inj 0.2 mg/mL
Contraindications
- Hypertension
- Toxemia
- Pregnancy (uterotonic effects)
Adverse reactions
- Hypertension (most common; several cases with seizure and/or headache)
- Hypotension
- Abdominal pain (uterine contractions)
- Nausea, vomiting
- Rare: acute MI, coronary artery spasm/vasospasm, chest pain, bradycardia/tachycardia, dyspnea
- Postmarketing: CVA, ventricular fibrillation/tachycardia, angina, AV block
Pregnancy Contraindicated during pregnancy due to uterotonic effects
Lactation Undefined
Cost
| Strength | #/mo | generic $ | CostPlus | |
|---|---|---|---|---|
| 0.2 mg | tab | 90 TID | $404.75/mo | offered |
| 0.2 mg/mL | inj | per unit | not offered |
NO BOXED WARNINGS
Principal riskContraindicated in hypertension and pre-eclampsia
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityHypertension, coronary vasospasm and dangerous uterine contractions