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Postpartum and post-abortion bleeding, 3rd stage of labour, Uterine bleeding, Postpartum haemorrhage
Adult Dose
Pospartum or Postabortion Hemorrhage
Oral: 0.2-0.4 mg PO q6-12hr PRN for 48 hr or until danger of uterine atony has passed; no more than 1 week
Parental
0.2 mg IM; may repeat in 2-4hr; not to exceed 5 doses total
Give IV only in emergency because of potential for HTN & CVA
Give over >1 minute & monitor BP
Contraindication
Pregnancy, 1st and 2nd stage of labour, patients with preeclampsia, eclampsia or threatened spontaneous abortion; porphyria.
Mode of Action
Ergometrine causes contraction of the uterine muscle. At low doses, there is an increase in frequency and amplitude of contractions while at higher doses, the basal tone of the uterus is increased. Ergometrine also causes vasoconstriction of peripheral and cerebral vessels.
Precaution
Breech and abnormal foetal presentation; hypertension; chronic anaemia; hepatic, renal, respiratory or cardiac impairment; toxemia; lactation; hypocalcaemia. Monitor BP, pulse and uterine response.
Lactation: excreted in milk; adverse effect on the nursing infant; may inhibit lactation; use not recommended
Side Effect
Nausea, vomiting, abdominal pain, diarrhoea; headache, dizziness; tinnitus; chest pain, palpitation, bradycardia, transient hypertension and other cardiac arrhythmias; dyspnoea, sometimes rashes, shock.
Potentially Fatal: MI, pulmonary oedema.
Interaction
Halothane causes relaxation of uterine muscle and may interfere with ergometrine action. Enhanced uterotonic effect with prostaglandins and oxytocin. Concurrent admin with CYP3A4 inhibitors may lead to vasospasm, cerebral ischaemia and/or ischaemia of extremities.
Potentially Fatal: Enhanced vasoconstrictive effects with sympathomimetics and other vasoconstrictors.
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