Ergometrine Maleate

Indications & Dose:

Management of peurperium, uterine haemorrhage, uterine subinvolution..

DOSE:

Orally:1 tab three times daily for three to four days in puerperium.

Bleeding due to incomplete abortion can be controlled with ergometrine and oxytocin , the dose being adjusted according to the patient’s condition and blood loss. This is commonly used prior to surgical evacuation of the uterus, particularly when surgery is delayed. Oxytocin and ergometrine combined are more effective in early pregnancy than either drug alone.

For the routine management of the third stage of labour ergometrine 500 micrograms with oxytocin 5 units (oxytocin 1mL) is given by intramuscular injection with or after delivery of the shoulders. For the prevention of postpartum haemorrhage in highrisk cases, intravenous injection of either ergometrine 125-250 micrograms alone or oxytocin 5-10 units is recommended, after delivery of the shoulders (repeated if necessary); alterna-tively intravenous infusion of oxytocin 10-20 units/500mL can be given after delivery of the shoulders, particularly when the uterus is atonic.

In domiciliary obstetric practice small secondary postpartum haemorrhage may be treated with ergometrine by mouth in a dose of 500 micrograms three times daily for 3 days.

Contraindications:

Induction of labour, 1st and second stage of labour, hepatic, peripheral vascular disease, coronary heart disease, renal failure, raynauds syndrome, impaired pulmonary function, sepsis, severe hypertention, eclampsia

Side Effects:

Nausea, vomiting, headache, dizziness, chest pain, dyspnea, bradycardia, transient hypotention, vasoconstriction; stroke, myocardial infarction & pulmonary oedema

Cautions:

Risk of peripheral vasospasm in elderly should not be used.  Cardiac disease, hypertention, hepatic & renal impairment, multiple pregnancy; porphyria. 

Precautions:

Interaction:

Drugs
Erythromycin, beta blockers.
SPECIAL CONSIDERATIONS: Symptoms of ergotism occur with overdosage (nausea, vomiting, diarrhea, seizure, hallucinations delirium, numb/ gangrenous extremities)
MONITORING PARAMETERS Blood pressure, pulse, and uterine response 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: