Methergine (Methylergonovine Oral)

Generic name: Methylergonovine maleate

Drug class: Ergot alkaloids

Dosage form: Oral tablets

Route of administration: Oral

Dose: 0.2 mg three or four times daily for up to 1 week after childbirth

Mechanism of action: Methylergonovine acts directly on the smooth muscle of the uterus, increasing the tone, rate, and amplitude of rhythmic contractions. This induces a rapid and sustained uterotonic effect, which shortens the third stage of labor and reduces blood loss.

Drug usage cases:

• Prevention and control of postpartum hemorrhage due to uterine atony
• Facilitation of uterine involution after childbirth or abortion

Drug contraindications:

• Hypersensitivity to methylergonovine or other ergot alkaloids
• Uncontrolled hypertension
• Preeclampsia or eclampsia
• Coronary artery disease
• Peripheral vascular disease
• Sepsis
• During pregnancy (except after delivery)

Side effects:

• Hypertension (severe headache, blurred vision, pounding in neck or ears)
• Chest pain, sweating, pounding heartbeats or fluttering in chest
• Seizures
• Numbness, tingling, or cold feeling in fingers or toes
• Light-headedness, fainting
• Sudden numbness or weakness on one side of the body, problems with vision or speech, pain or swelling in one leg
• Headache
• Nausea
• Vomiting
• Dizziness

Warnings:

• Monitor blood pressure regularly; do not administer if blood pressure exceeds parameters set by provider
• Administer intravenously slowly over at least 1 minute to minimize adverse effects
• Monitor for signs of ergot toxicity, such as cold limbs, chest pain, or hallucinations
• Do not breast-feed within 12 hours after using methylergonovine; discard any milk collected during this period

Use during pregnancy or breastfeeding:

Methylergonovine is contraindicated during pregnancy except after delivery. It should not be used during labor or before the delivery of the placenta.

Do not breast-feed within 12 hours after using methylergonovine. If you use a breast pump during this time, discard any milk you collect; do not feed it to your baby.