Miscellaneous Ob/Gyn conditions:

Indications for: METHERGINE

Following delivery of the placenta, for routine management of uterine atony, hemorrhage, and subinvolution of the uterus. For control of uterine hemorrhage in the second stage of labor following delivery of the anterior shoulder.

Adult Dosage:

0.2mg 3–4 times a day in the puerperium for max 1 week.

Children Dosage:

Not established.

METHERGINE Contraindications:

Hypertension. Toxemia. Pregnancy (Cat.C).

METHERGINE Warnings/Precautions:

Avoid intra-arterial, periarterial injection. Coronary artery disease or risk factors; may be more susceptible to developing MI and infarction associated with methylergonovine-induced vasospasm. Sepsis. Obliterative vascular disease. Hepatic or renal disease. 2nd stage of labor. Nursing mothers: not recommended (wait at least 12hrs after last dose before initiating or resuming feeding).

METHERGINE Classification:

Ergot alkaloid.

METHERGINE Interactions:

Potentiated by vasoconstrictors, other ergot alkaloids, prostaglandins, beta-blockers. Potent CYP3A4 inhibitors (eg, macrolides, protease inhibitors, reverse transcriptase inhibitors, azole antifungals): not recommended. Use caution with less potent CYP3A4 inhibitors (eg, saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxamine, zileuton, clotrimazole). Antagonized by strong inducers of CYP3A4 (eg, nevirapine, rifampicin), anesthetics (eg, halothane, methoxyflurane). Antagonizes glyceryl trinitrate, other antianginal drugs.

Adverse Reactions:

Hypertension associated with seizure and/or headache, hypotension, abdominal pain, GI upset; rare: cardiovascular effects (eg, vasoconstriction, acute MI, transient chest pains).

Metabolism:

Hepatic.

Drug Elimination:

Fecal.

Generic Drug Availability:

YES

How Supplied:

Tabs—7, 12, 28, 100; Inj (1mL amps)—20