Adult Dosing

Postpartum bleeding

• 0.2 mg PO tid-qid in the puerperium, as needed. [Max: 1 wk]

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• For routine management of uterine atony, hemorrhage and subinvolution of the uterus
• Administered for control of uterine hemorrhage in 2nd stage of labor following delivery of the anterior shoulder

• Hypersensitivity to any of the ingredients of the product
• Hypertension
• Pregnancy
• Toxemia
• Intra-arterial or periarterial injection
• Concomitant use with potent CYP 3A4 inhibitors

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined; use with caution

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined; use with caution

• Avoid frequent use of IV administration; it may cause sudden hypertensive and cerebrovascular accidents. Use of drug through IV is consider as a lifesaving measure, it should be given slowly over a period of 60 seconds and monitor blood pressure carefully
• Avoid intra-arterial or periarterial injection
• It should not be used to induce labor
• Mothers should not breastfeed during treatment and discard milk secreted during this period. Breastfeeding may be resumed at least 12 hrs after last dose. Therapy may produce adverse events in the breast-feeding infant and also decrease the yield of breast milk
• Inadvertent administration to newborn infants has reported with methylergonovine. Due to accidental neonatal exposure to methylergonovine it should be stored separately from medications intended for neonates
• Increased risk for myocardial ischemia and infarction in patients with coronary artery disease (CAD) associated with methylergonovine-induced vasospasm

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Obliterative vascular disease
• Second stage of labor
• Sepsis
• Raynaud's phenomenon
• History on TIAs
• Use during 2nd stage labor
• Recent MI
• Angina

Pregnancy Category:C; Contraindicated during pregnancy due to its uterotonic activity.

Breastfeeding: Limited information indicates that maternal doses up to 0.75 mg/day produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants. However it can decrease serum prolactin and possibly suppress lactation, especially when used in the immediate postpartum period. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 31 May 2011). Manufacturer advises caution in nursing women.

• CNS: Headache, seizure
• CV: Hypertension, hypotension, arterial spasm
• GI: Nausea, vomiting
• MISC: Tinnitus, Anaphylaxis, Seizure

• Uterine stimulant; it acts directly on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions
• Metabolized by liver
• Excretion: Feces
• Half life: 3.39 hrs

US Trade Name(s)

• Methergine

US Availability

methylergonovine (generic)

• TABS: 0.2 mg

Methergine

• TABS: 0.2 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Obstetrics/Gynecology

Oxytocics

Ergot Alkaloids

Drug Name: Methergine 0.2 MG Oral Tablet

Ingredient(s): Methylergonovine

Imprint: 78;54;SANDOZ

Color(s): Purple

Shape: Round

Size (mm): 6.00

Score: 1

Inactive Ingredient(s): acacia / carnauba wax / gelatin / lactose / maleic acid / povidone / sodium benzoate / sodium hydroxide / stearic acid / sucrose / talc / titanium dioxide

Drug Label Author:
Apotheca, Inc.

DEA Schedule:
Non-Scheduled

Drug Name: Methergine 0.2 MG Oral Tablet

Ingredient(s): Methylergonovine

Imprint: 78;54;SANZOZ

Color(s): Purple

Shape: Round

Size (mm): 6.00

Score: 1

Inactive Ingredient(s): acacia / carnauba wax / d&c red no. 7 / fd&c blue no. 1 / gelatin / lactose / maleic acid / propylparaben / povidone / sodium benzoate / sodium hydroxide / starch, corn / stearic acid / sucrose / talc / titanium dioxide / methylparaben

Drug Label Author:
Novartis Pharmaceuticals Corporation

DEA Schedule:
Non-Scheduled