Ergometrine Maleate

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Generic Name of Ergometrine Maleate - Learn More

Ergometrine Maleate

Ergometrine Maleate Precaution - What You Need to Know

Ergometrine maleate, an ergot alkaloid, is primarily used to control postpartum hemorrhage and to facilitate the expulsion of the placenta by inducing uterine contractions. It should be used with caution in patients with a history of hypertension, preeclampsia, or eclampsia, as the drug can cause vasoconstriction and increase blood pressure. Ergometrine should also be carefully monitored in patients with coronary artery disease, as it may induce vasospasm or worsen ischemic conditions.

During pregnancy, ergometrine should only be used in the postpartum period and in carefully controlled settings due to its potent uterotonic effects. Its use during labor or in the first or second trimester is contraindicated, as it can cause premature labor or induce uterine rupture. Caution should be exercised in breastfeeding mothers, as ergometrine is excreted in breast milk, and its use could potentially harm the infant, especially in high doses.

For patients with liver or renal impairment, dose adjustments may be required due to the drug’s hepatic metabolism and renal excretion. Monitoring of blood pressure and uterine activity is essential during treatment, and the drug should be discontinued immediately if excessive uterine contractions or signs of toxicity occur.

Ergometrine Maleate Indication - Uses and Benefits

Ergometrine maleate is indicated for the prevention and treatment of postpartum hemorrhage caused by uterine atony (failure of the uterus to contract after childbirth). It is used to stimulate uterine contractions and promote the expulsion of the placenta. Ergometrine is also used in managing uterine hemorrhage following surgical procedures or in cases where the uterus remains relaxed and uncontracted after childbirth, which could lead to excessive bleeding.

Ergometrine may be used in emergency situations for its hemostatic effects, especially in cases of severe bleeding after delivery. It is not recommended for use during labor to induce or enhance uterine contractions due to the risk of adverse effects like uterine rupture. In certain cases, ergometrine is used off-label for the management of abortion, though this is highly controlled and typically only under specific medical guidance due to its uterotonic effects.

Ergometrine Maleate Contraindications - Important Warnings

Ergometrine maleate is contraindicated in patients with a history of hypersensitivity to ergot alkaloids or any of its excipients. It should not be used in women who are pregnant for reasons other than controlling postpartum hemorrhage, as it can induce uterine contractions, leading to premature labor, miscarriage, or uterine rupture. It is also contraindicated in patients with high blood pressure (especially uncontrolled hypertension), as it can cause vasoconstriction and potentially exacerbate the condition.

Ergometrine should not be used in patients with coronary artery disease, peripheral vascular disease, or other conditions that involve impaired circulation, as it can induce vasospasm and worsen ischemic conditions. Additionally, it is contraindicated in patients with severe hepatic or renal dysfunction, as the drug’s metabolism and excretion are dependent on these organs. Ergometrine is also contraindicated in breastfeeding mothers unless absolutely necessary, as it may be secreted into breast milk and cause adverse effects in the infant.

Ergometrine Maleate Side Effects - What to Expect

The most common side effects of ergometrine maleate are related to its uterotonic effects and include nausea, vomiting, and abdominal pain. It can also cause significant vasoconstriction, leading to elevated blood pressure, chest pain, and, in rare cases, ischemic events such as myocardial infarction. Other common side effects include dizziness, headache, and sweating.

Serious side effects are relatively rare but can include severe hypertension, which could lead to hypertensive crises, strokes, or cardiovascular events. Ergometrine can also cause uterine hyperstimulation, which increases the risk of uterine rupture, fetal distress, or placental abruption. Other serious effects may include gangrene in extreme cases of vasoconstriction, especially in patients with pre-existing vascular disease.

To mitigate side effects, ergometrine should be administered carefully under medical supervision, with close monitoring of the patient’s blood pressure, uterine tone, and overall response to the drug. If signs of vasospasm or excessive uterine contractions occur, the drug should be discontinued immediately. Adequate hydration and oxygenation should be provided if adverse effects arise.

Ergometrine Maleate Pregnancy Category ID - Safety Information

5

Ergometrine Maleate Mode of Action - How It Works

Ergometrine maleate exerts its therapeutic effect by stimulating alpha-adrenergic and serotonin receptors in the smooth muscle of the uterus. This stimulation induces strong, sustained uterine contractions, which are essential for controlling postpartum hemorrhage by compressing blood vessels and reducing bleeding. Additionally, ergometrine causes vasoconstriction, primarily affecting peripheral vessels, and this action helps to reduce blood loss by constricting dilated blood vessels.

The drug’s pharmacokinetics show that it is absorbed quickly following intramuscular or intravenous administration, and it has a relatively short half-life. Ergometrine is metabolized in the liver and excreted via the kidneys. Its pharmacodynamic effects are mainly localized to the uterus and vascular smooth muscle, with systemic effects on blood pressure and circulation due to its vasoconstrictive properties.

Ergometrine Maleate Drug Interactions - What to Avoid

Ergometrine maleate interacts with a variety of medications, particularly those that affect blood pressure or uterine tone. Concomitant use with vasoconstrictors such as sympathomimetic drugs (e.g., norepinephrine) or adrenergic agents can increase the risk of vasospasm and hypertension, as ergometrine already has vasoconstrictive properties.

It should also be used with caution when combined with other uterotonic agents, including oxytocin, as their combined effects could result in overly strong uterine contractions, increasing the risk of uterine rupture or fetal injury. Additionally, ergometrine may interact with medications that affect liver function (e.g., CYP450 inhibitors), potentially altering its metabolism and leading to increased plasma levels and a higher risk of toxicity.

Ergometrine is known to interact with certain antidepressants, such as monoamine oxidase inhibitors (MAOIs), as this combination may lead to excessive vasoconstriction and increased blood pressure. Therefore, patients on MAOIs should avoid ergometrine, and any changes in medication should be monitored closely.

Ergometrine Maleate Adult Dose - Recommended Dosage

For the prevention of postpartum hemorrhage, the typical adult dose of ergometrine maleate is 0.2 to 0.4 mg, administered intramuscularly or intravenously immediately after the delivery of the placenta. The dose may be repeated after 2 to 4 hours if necessary, but the total dose should not exceed 1 mg in 24 hours.

For the treatment of ongoing postpartum hemorrhage, ergometrine may be given intravenously in an emergency setting, typically at a dose of 0.2 mg to 0.4 mg every 2 to 4 hours, as needed, until the bleeding is controlled. It is crucial to monitor the patient for signs of excessive uterine contractions or hypertension, and the dose should be reduced or discontinued if adverse effects are observed.

Ergometrine Maleate Child Dose - Dosage for Children

Ergometrine maleate is generally not recommended for use in children due to a lack of sufficient safety and efficacy data in pediatric populations. Its uterotonic effects, which are beneficial in controlling postpartum hemorrhage in adults, may pose significant risks for children, particularly due to the potential for inducing premature labor or excessive uterine contractions. If ergometrine must be used in a pediatric setting, such as in emergency situations, careful consultation with a pediatric specialist is necessary, and dosing should be individualized based on the child's age, weight, and clinical condition.

In all cases, non-ergot uterotonic agents (such as oxytocin) are preferred for pediatric patients requiring treatment for uterine hemorrhage.

Ergometrine Maleate Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, the clearance of ergometrine maleate may be reduced, leading to increased plasma levels and a higher risk of toxicity. However, no specific renal dosing adjustments have been established. In these patients, the drug should be used cautiously, and close monitoring of renal function and blood pressure is essential during treatment. If renal function significantly declines, alternative therapies should be considered to avoid excessive buildup of ergometrine in the system.

For patients on dialysis, careful consideration is needed as the drug may not be effectively removed by hemodialysis, and dosing should be tailored to the patient’s clinical condition.