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.
0.2mg 3–4 times a day in the puerperium for max 1 week.
Hypertension. Toxemia. Pregnancy (Cat.C).
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).
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.
Hypertension associated with seizure and/or headache, hypotension, abdominal pain, GI upset; rare: cardiovascular effects (eg, vasoconstriction, acute MI, transient chest pains).
Generic Drug Availability:
Tabs—7, 12, 28, 100; Inj (1mL amps)—20