Ergometrine

Ergometrine (ergonovine) is a medicinal product that contains the active substance ergotamine in its composition and may also include additional ingredients. Ergometrine is an alkaloid from the ergot family and has the ability to stimulate the contractile activity of smooth muscles, including the uterus.

The drug is often used in obstetrics and gynecology for a variety of purposes, including the following:

1. Stimulation of labor: This medicine can be used to speed up labor in cases of delayed or weak uterine activity. It helps to strengthen uterine contractions and may help in the normal labor process.
2. Control of postpartum hemorrhage: After delivery, the drug may be used to prevent or reduce bleeding associated with uterine atony (insufficient uterine contractility).
3. Migraine Treatment: Ergometrine can also be used as a medication to treat and prevent migraine. It is able to constrict blood vessels, which can help reduce the intensity and frequency of migraine attacks.

As with any medication, the drug may cause side effects, including nausea, vomiting, seizures, headache, increased blood pressure, rapid heartbeat and others. The drug should be used only as prescribed by a doctor and the dosage should be strictly followed to avoid possible complications.

Indications Ergometrine

1. Speeding up or maintaining labor: Ergometrine is used to stimulate uterine contractions and speed up labor in cases of delayed or ineffective labor. It helps to improve uterine tone and speed up the labor process.
2. Prevention or treatment of postpartum bleeding: After childbirth, the drug may be used to prevent or treat bleeding caused by uterine atony (insufficient uterine contractility after childbirth).
3. Medical abortion: In some cases, ergometrine may be used during medical abortion (induced abortion).
4. Migraine treatment: Some doctors may prescribe a drug to treat and prevent migraines. It may help narrow dilated blood vessels, which helps reduce migraine symptoms.
5. Diagnosis of vascular disease: The drug is sometimes used as an agent to diagnose vascular disease such as vascular spasms

Release form

Ergometrine is usually available as a solution for injection. This medicine comes in ampoules or vials and is intended for intramuscular or intravenous injection.

The release forms of ergometrine may vary depending on the manufacturer and region. It is usually supplied as a solution with the concentration of active ingredient (usually 0.2 mg/mL) and volume in ampoules or vials.

The drug is used to treat a variety of conditions, including controlling postpartum hemorrhage, treating or preventing uterine hypotony during labor or abortion, and for certain gynecologic procedures.

It is important to consult your doctor or other health care professional to determine the correct dosage and route of administration for your particular case.

Pharmacodynamics

Ergometrine is an alkaloid that is used in medicine as a myotropic antispasmodic and uterotropic agent. Its mechanism of action is related to its ability to interact with receptors on smooth muscle cells of various organs, including the uterus.

Key aspects of pharmacodynamics and mechanism of action include:

1. Uterinevasoconstriction: Ergometrine stimulates α1-adrenergic receptors on the smooth muscle cells of the uterine wall, which leads to their contraction and uterine vasoconstriction. This helps to reduce blood flow in the uterus.
2. Increasing uterine tone: The drug also increases the tone of the uterus, which helps to contract its muscle fibers. This may be useful during labor, to prevent or reduce bleeding after delivery, and to control bleeding during abortion.
3. Reducing blood flow in the uterus: By contracting uterine vessels and increasing uterine tone, ergometrine helps reduce blood flow in the uterus and therefore controls bleeding.
4. Prolonged vasoconstriction: The drug is long-acting, which means that its effect on blood vessels and uterine tone can last long enough to provide effective reduction of bleeding.

Pharmacokinetics

1. Absorption: Ergometrine is usually injected into the body intramuscularly or intravenously. After administration, the drug is rapidly absorbed from the site of administration.
2. Distribution: The drug has good distribution in body tissues, including uterine myometrium.
3. Metabolism: Ergometrine is metabolized in the liver. It can undergo hydroxylation and conjugation with glucuronic acid, forming inactive metabolites.
4. Excretion: Metabolites are eliminated from the body mainly through the kidneys.
5. Concentration: Maximum blood concentrations of ergometrine are usually reached within 15-30 minutes after intravenous administration.
6. Pharmacodynamics: The drug is an ergotxic alkaloid, which acts as an agonist of α1-adrenoreceptors and serotonin receptors. Its main effect is contraction of the uterine myometrium, which contributes to blood vessel contraction and reduction of bleeding.
7. Duration of action: Ergometrine has a longduration of action, usually the effect lasts about 2-6 hours after administration.
8. Interactions with other drugs: The drug may interact with other drugs, especially adrenergic agonists and agents that increase blood pressure.

Dosing and administration

The following are general recommendations for method of use and dosage, but it is important to consult your physician as dosage may vary depending on your specific situation and medical conditions:

1. Control of postpartum hemorrhage:

   • Intramuscular injection of ergometrine after delivery is usually recommended to prevent or reduce bleeding.
   • Dosage: Usually 0.2 mg (1 ampoule) of ergometrine is given intramuscularly, but sometimes it may need to be given again after a few hours if bleeding continues.

2. Management of uterine hypotony during labor or abortion:

   • If the uterus is underactive during labor or abortion, intravenous administration of the drug may be required to stimulate uterine contractions.
   • Dosage: The usual starting dose is 0.2 mg (1 ampule) of ergometrine, which may be repeated as needed, usually at intervals of 15 minutes to 2 hours, depending on uterine response.

3. Other medical procedures:

   • Ergometrine may also be used in other gynecologic procedures, and the dosage may vary depending on the specifics of the procedure and the physician's requirements.

Use Ergometrine during pregnancy

Ergometrine is a drug used to control bleeding after childbirth and to prevent and treat postpartum uterine atony.

However, the use of ergometrine during pregnancy requires special attention and caution. In many countries, its use during pregnancy is generally not recommended because of the risk of possible uterine spasm and subsequent decreased blood supply to the fetus.

In some cases, such as threatened preterm labor or controlled bleeding, a doctor may decide to prescribe ergometrine to a pregnant woman when the benefits of the drug outweigh the potential risks.

However, the use of the drug during pregnancy should take place under the strict supervision of a doctor and only if there are clear indications. It is important that the decision to use this drug is made by a doctor, taking into account all the circumstances and peculiarities of a particular situation.

Contraindications

1. Hypertension: Since ergometrine is capable of constricting blood vessels, its use may be contraindicated in hypertensive patients, as it may lead to an increase in blood pressure.
2. Cardiovascular diseases: In patients with serious cardiovascular diseases, such as ischemic heart disease, heart rhythm disorders or atherosclerosis, the use of the drug may be contraindicated due to its potential effect on the cardiovascular system.
3. Hypersensitivity: People with known hypersensitivity or allergy to ergometrine or other constituents of the drug should avoid its use.
4. Renal insufficiency: The drug should be used with caution in patients with impaired renal function due to its metabolism and excretion through the kidneys.
5. Hepatic insufficiency: Caution should also be exercised when using the drug in patients with hepatic insufficiency due to its metabolism in the liver.
6. Hemorrhagic disorders: In the presence of hemorrhagic disorders or a tendency to hemorrhagic disorders, the use of the drug may be contraindicated due to its ability to increase uterine contractility and cause bleeding.
7. Pregnancy: During pregnancy, ergometrine should be used only under the strict supervision of a physician and only when the benefits outweigh the potential risks to the fetus.

Side effects Ergometrine

1. Uterine cramps: This is one of the most common side effects. The drug stimulates uterine contractions, and sometimes this can cause severe labor pains or increased labor contractions.
2. Headache: Patients may experience headaches or migraines while using the drug.
3. Nausea and vomiting: These side effects may also occur in some people after taking the drug.
4. Hypertension: Ergometrine may cause an increase in blood pressure in some patients.
5. Dizzinessor weakness: Some people may feel dizzy or weak after taking this medicine.
6. Other rare side effects: Other rare side effects may also occur, including allergic reactions, fainting, insomnia, or chest pain.

Overdose

An overabundance of this drug can lead to severe complications, including:

1. Increased uterine contractions: An overdose of ergometrine can cause strong and prolonged uterine contractions, which can lead to uterine hypertonicity, pain, and even possible disruption of the blood supply to the fetus during pregnancy.
2. Arterial hypertension: The drug also has an effect on vascular tone, and excessive use may cause arterial hypertension (increased blood pressure), which may lead to headache, dizziness, nausea and vomiting.
3. Vascular complications: Excess ergometrine can cause vasoconstriction of blood vessels, including coronary arteries, which can lead to ischemia of the heart muscle and even myocardial infarction in individuals with a predisposition to heart disease.
4. Heart rhythm disorders: An overdose of ergometrine may cause heart rhythm disorders, including arrhythmias such as tachycardia (quickening of the heart rate) or arrhythmias, which can lead to serious heart complications.

Interactions with other drugs

1. Drugs that increase blood pressure: Ergometrine, being an α1-adrenoreceptor agonist, may increase the effect of other drugs that also increase blood pressure, such as sympathomimetics or adrenergic stimulants.
2. Antihypertensive drugs: Blood pressure-lowering drugs may reduce the effectiveness of the drug when administered concomitantly.
3. Drugs affecting the cardiovascular system: Ergometrine may increase the effects of other drugs affecting the cardiovascular system, such as cardiac glycosides or antiarrhythmic drugs.
4. Monoamine oxidase inhibitors (MAOIs): MAOIs may potentiate the effects of the drug and lead to increased blood pressure and other undesirable effects.
5. Drugsthat reduce the acidity of gastric juice: Drugs such as proton inhibitors and antacids may reduce the absorption of ergometrine from the gastrointestinal tract and therefore reduce its efficacy.
6. Oxytocin: Concomitant use of the drug andoxytocin may increase their effects on uterine contraction, which may increase the risk of uterine hypertonicity and abdominal contractions.
7. Drugs affecting the central nervous system: The drug may increase the sedative or stimulant effects of drugs affecting the central nervous system, such as benzodiazepines or stimulants.

Storage conditions

Ergometrine as a medicine is usually stored under certain conditions to maintain its effectiveness and safety. Commonly recommended storage conditions for the drug include:

1. Temperature: Ergometrine should be stored at controlled room temperature, usually 20 to 25 degrees Celsius (68 to 77 degrees Fahrenheit).
2. Light: The drug should be stored in a place protected from light. Direct exposure to sunlight may lead to decomposition of active components of the drug.
3. Humidity: The product should be protected from excessive humidity to prevent mold growth and maintain its stability.
4. Packaging: The drug should be stored in its original packaging or container to minimize the impact of external factors on its quality.
5. Additional instructions: It is important to follow the instructions on the package or your healthcare professional's instructions for storing the drug. Some drugs may have special storage requirements that may vary by manufacturer.