meth-ill-er-goe-NOE-veen

• Prevention and treatment of postpartum or postabortion hemorrhage caused by uterine atony or subinvolution.

• Directly stimulates uterine and vascular smooth muscle.

• Uterine contraction.

Absorption: Well absorbed following oral or IM administration.

Distribution: Unknown. Enters breast milk in small quantities.

Metabolism/Excretion: Probably metabolized by the liver.

Half-life: 30–120 min.

Contraindicated in:

• Hypersensitivity
• OB: Should not be used to induce labor
• Lactation: Do not breast feed during treatment and for 12 hrs after the last dose
• Concurrent use of potent CYP3A4 inhibitors

Use Cautiously in:

• Hypertensive or eclamptic patients (more susceptible to hypertensive and arrhythmogenic side effects)
• History of or risk factors for coronary artery disease
• Severe hepatic or renal disease
• Sepsis
• Concurrent use of moderat CYP3A4 inhibitors.

Exercise Extreme Caution in:

• OB: Third stage of labor.

EENT: tinnitus.

Resp: dyspnea.

CV: HYPERTENSION, arrhythmias, AV block, chest pain, palpitations.

GI: nausea, vomiting.

GU: cramps.

Derm: diaphoresis.

Neuro: paresthesia , STROKE, dizziness, headache.

Misc: allergic reactions.

Drug-Drug:

• Excessive vasoconstriction may result when used with heavy cigarette smoking (nicotine), other vasopressors, such as dopamine, or beta-blockers.
• Potent CYP3A4 inhibitors, including erythromycin, clarithromycin, troleandomycin, ritonavir, indinavir, nelfinavir, delavirdine, ketoconazole, itraconazole, or voriconazole may ↑ levels and ↑ risk of ischemia; concurrent use contraindicated
• Moderate CYP3A4 inhibitors including saquinavir, nefazodone, fluconazole, fluoxetine, fluvoxamine, zileuton, or clotrimazole may ↑ levels; use with caution
• CYP3A4 inducers including nevirapine and rifampin may ↓ levels
• Anesthetics may ↓ its oxytocic properties
• May ↓ the antianginal effects of nitrates.

Drug-Food:

• Grapefruit juice may ↑ levels; use with caution

• PO (Adults): 200–400 mcg (0.2–0.4 mg) every 6–12 hr for 2–7 days.
• IM, IV (Adults): 200 mcg (0.2 mg) every 2–4 hr for up to 5 doses.

IV Administration:

• IV: IV administration is used for emergencies only. Oral and IM routes are preferred.
• IV Push:
  Diluent: May be given undiluted or diluted in 5 mL of 0.9% NaCl and administered through Y site. Do not add to IV solutions. Do not mix in syringe with any other drug. Refrigerate; stable for storage at room temperature for 60 days; deteriorates with age. Use only solution that is clear and colorless and that contains no precipitate.Concentration: 0.2 mg/mL.
• Rate: Administer at a rate of 0.2 mg over at least 1 min.
• Y-Site Compatibility:
  • heparin
  • hydrocortisone sodium succinate
  • potassium chloride
  • vitamin B complex with C
.

Methergine

Therapeutic Classification: oxytocics

Pharmacologic Classification: ergot alkaloids

(Generic available)

• Tablets: 200 mcg (0.2 mg);
• Injection: 200 mcg (0.2 mg)/mL;

(effects on uterine contractions)

• Monitor BP, heart rate, and uterine response frequently during medication administration. Notify health care professional promptly if uterine relaxation becomes prolonged or if character of vaginal bleeding changes.
• Assess for signs of ergotism (cold, numb fingers and toes, chest pain, nausea, vomiting, headache, muscle pain, weakness).

• If no response to methylergonovine, calcium levels may need to be assessed. Effectiveness of medication is ↓ with hypocalcemia.
  • May cause ↓ serum prolactin levels.

• Acute pain (Side Effects).

• Instruct patient to take medication as directed; do not skip or double up on missed doses. If a dose is missed, omit it and return to regular dose schedule.
• Advise patient that medication may cause menstrual-like cramps.
• Caution patient to avoid smoking, because nicotine constricts blood vessels.
• Instruct patient to notify health care professional if infection develops, as this may cause increased sensitivity to the medication.
• Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.

• Contractions that maintain uterine tone and prevent postpartum hemorrhage.

NDC Code^*

• 0054- West-Ward Pharmaceuticals Corp
  • 0054-0639- Methylergonovine Maleate
    • 0054-0639-03- 7 TABLET in 1 BOTTLE (0054-0639-03)

• 0054- West-Ward Pharmaceuticals Corp
  • 0054-0639- Methylergonovine Maleate
    • 0054-0639-05- 12 TABLET in 1 BOTTLE (0054-0639-05)

• 0054- West-Ward Pharmaceuticals Corp
  • 0054-0639- Methylergonovine Maleate
    • 0054-0639-13- 28 TABLET in 1 BOTTLE (0054-0639-13)

• 0054- West-Ward Pharmaceuticals Corp
  • 0054-0639- Methylergonovine Maleate
    • 0054-0639-25- 100 TABLET in 1 BOTTLE (0054-0639-25)

• 0093- Teva Pharmaceuticals USA, Inc.
  • 0093-3655- Methylergonovine Maleate
    • 0093-3655-22- 12 TABLET in 1 BOTTLE (0093-3655-22)

• 0093- Teva Pharmaceuticals USA, Inc.
  • 0093-3655- Methylergonovine Maleate
    • 0093-3655-28- 28 TABLET in 1 BOTTLE (0093-3655-28)

• 0517- American Regent, Inc.
  • 0517-0740- Methylergonovine Maleate
    • 0517-0740-20- 20 VIAL, SINGLE-DOSE in 1 CARTON (0517-0740-20) > 1 mL in 1 VIAL, SINGLE-DOSE (0517-0740-01)

• 17478- Akorn, Inc.
  • 17478-501- Methylergonovine Maleate
    • 17478-501-01- 10 AMPULE in 1 CARTON (17478-501-01) > 1 mL in 1 AMPULE

• 27437- Lupin Pharma
  • 27437-050- Methergine
    • 27437-050-01- 100 TABLET in 1 BOTTLE (27437-050-01)

• 27437- Lupin Pharma
  • 27437-050- Methergine
    • 27437-050-19- 7 TABLET in 1 BOTTLE (27437-050-19)

• 27437- Lupin Pharma
  • 27437-050- Methergine
    • 27437-050-56- 28 TABLET in 1 BOTTLE (27437-050-56)

• 27437- Lupin Pharma
  • 27437-050- Methergine
    • 27437-050-57- 12 TABLET in 1 BOTTLE (27437-050-57)

• 40032- Novel Laboratories, Inc.
  • 40032-140- Methylergonovine Maleate
    • 40032-140-01- 100 TABLET in 1 BOTTLE (40032-140-01)

• 40032- Novel Laboratories, Inc.
  • 40032-140- Methylergonovine Maleate
    • 40032-140-07- 7 TABLET in 1 BOTTLE (40032-140-07)

• 40032- Novel Laboratories, Inc.
  • 40032-140- Methylergonovine Maleate
    • 40032-140-28- 28 TABLET in 1 BOTTLE (40032-140-28)

• 43386- Lupin Pharmaceuticals,Inc.
  • 43386-140- Methylergonovine Maleate
    • 43386-140-01- 100 TABLET in 1 BOTTLE (43386-140-01)

• 43386- Lupin Pharmaceuticals,Inc.
  • 43386-140- Methylergonovine Maleate
    • 43386-140-07- 7 TABLET in 1 BOTTLE (43386-140-07)

• 43386- Lupin Pharmaceuticals,Inc.
  • 43386-140- Methylergonovine Maleate
    • 43386-140-12- 12 TABLET in 1 BOTTLE (43386-140-12)

• 43386- Lupin Pharmaceuticals,Inc.
  • 43386-140- Methylergonovine Maleate
    • 43386-140-28- 28 TABLET in 1 BOTTLE (43386-140-28)

• 50090- A-S Medication Solutions
  • 50090-4536- METHYLERGONOVINE MALEATE
    • 50090-4536-0- 1 mL in 1 AMPULE (50090-4536-0)

• 51991- Breckenridge Pharmaceutical, Inc.
  • 51991-144- METHYLERGONOVINE MALEATE
    • 51991-144-17- 10 AMPULE in 1 BOX (51991-144-17) > 1 mL in 1 AMPULE

• 60687- American Health Packaging
  • 60687-410- Methylergonovine Maleate
    • 60687-410-94- 20 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-410-94) > 1 TABLET in 1 BLISTER PACK (60687-410-11)

• 63704- Pharmacist Pharmaceutical, LLC
  • 63704-004- METHYLERGONOVINE MALEATE
    • 63704-004-01- 10 AMPULE in 1 BOX (63704-004-01) > 1 mL in 1 AMPULE

• 69238- Amneal Pharmaceuticals NY LLC
  • 69238-1605- Methylergonovine Maleate
    • 69238-1605-2- 12 TABLET in 1 BOTTLE (69238-1605-2)

• 69238- Amneal Pharmaceuticals NY LLC
  • 69238-1605- Methylergonovine Maleate
    • 69238-1605-8- 28 TABLET in 1 BOTTLE (69238-1605-8)