II. Indications
-
Postpartum Hemorrhage
- After delivery of the anterior Shoulder and placenta
- Uterine Hemorrhage
- Dilation and Curettage associated Hemorrhage
- Early Pregnancy Loss associated Hemorrhage
- Uterine Inversion associated Hemorrhage (following Uterus replacement)
III. Contraindications
- Hypertension
- Pregnancy Induced Hypertension
- Methylergonovine Hypersensitivity
IV. Mechanism
- Methylergonovine (Methergine) is an Ergonovine homolog, with an added methyl group
- While Methylergonovine is primarily used in the U.S., Ergonovine is used elsewhere
- Methylergonovine is an ergot alkaloid
- Increases uterine tone and contraction
- Increases vascular smooth Muscle Contraction (Vasoconstriction)
- Methylergonovine has complex interactions at multiple receptors
- Adrenergic Receptors
- Dopamine receptors
- Tryptamine receptors
- Methylergonovine also decreases Prolactin levels
- May decrease Lactation
V. Dosing
- Precautions
- Dose after delivery of the anterior Shoulder and placenta
- Monitor Blood Pressure
- IM: 0.2 mg IM every 2 to 4 hours as needed for acute Postpartum Hemorrhage
- Avoid IV use (CVA, Hypertension), esp. given that IM onset of action is within 2 to 5 minutes
- If IV dose is used, infuse over >1 minute
- Oral: 0.2 mg orally every 6 to 8 hours postpartum (maximum of 1 week)
VI. Adverse Effects
- Cardiovascular
- Cardiac Arrhythmia
- Hypertension
- Paradoxical Hypotension has also been reported
- Neurologic
- Gynecologic
- Abdominal Pain or cramping
- Nausea or Vomiting
VII. Safety
- Avoid in Lactation
- Contraindicated in pregnancy (except postpartum or after pregnancy loss)
VIII. Pharmacokinetics
- Onset: 2 to 5 min after IM dosing (5 to 10 min after oral dosing)
- Bioavailability: 78% for IM (60% for oral)
IX. Resources
- Methylergonovine (DailyMed)
Images: Related links to external sites (from Bing)
Related Studies
| methylergonovine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| METHYLERGONOVINE 0.2 MG TABLET | Generic | $9.17 each |
Ontology: Methylergonovine (C0025760)
| Definition (MSH) | A homolog of ERGONOVINE containing one more CH2 group. (Merck Index, 11th ed) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D008755 |
| SnomedCT | 126074008, 40562000 |
| LNC | LP19145-9, MTHU007397 |
| English | Methylergobasin, Methylergometrin, Methylergonovine, Ergoline-8-carboxamide, 9,10-didehydro-N-(1-(hydroxymethyl)propyl)-6-methyl-, (8beta(S))-, Methylergonovine [Chemical/Ingredient], Methylergometrine, methylergometrine, methylergonovine, METHYLERGONOVINE, Methylergometrine preparation, Methylergonovine preparation, Methylergonovine (substance), Methylergonovine preparation (product), Methylergonovine preparation (substance) |
| Swedish | Metylergonovin |
| Czech | methylergonovin |
| Finnish | Metyyliergometriini |
| Russian | METILERGOBAZIN, METILERGONOVIN, METILERGOMETRIN, МЕТИЛЭРГОБАЗИН, МЕТИЛЭРГОМЕТРИН, МЕТИЛЭРГОНОВИН |
| Japanese | メチルエルゴバシン, メチルエルゴメトリン, メチルエルゴノビン |
| Spanish | metilergometrina (producto), preparado de metilergonovina (producto), metilergometrina, preparado de metilergometrina, preparado de metilergonovina, metilergonovina (sustancia), metilergonovina, preparado de metilergonovina (sustancia), Metilergobasina, Metilergometrina, Metilergonovina |
| Croatian | METILERGONOVIN |
| Polish | Metyloergometryna |
| French | Méthylergométrine |
| German | Methylergobasin, Methylergometrin, Methylergonovin |
| Italian | Metilergonovina |
| Portuguese | Metilergobasina, Metilergometrina, Metilergonovina |
