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What is Ergonovine
Ergonovine is an oral and parenteral ergot alkaloid.
Ergonovine, and its derivative, methylergonovine are preferentially used over the other ergot alkaloids in contemporary obstetric practice to prevent postpartum uterine atony and hemorrhage because they are most active of the ergot alkaloids on uterine tissues.
Like methylergonovine, ergonovine is not recommended for use prior to delivery of the placenta because of the high uterine tone induced by the drug.
Both ergonovine and methylergonovine are less likely than other ergot alkaloids to cause ergot-related toxicity with repeated oral dosing and a limited duration of normal prescription use.
The drugs are occasionally used off-label following first trimester abortion curettage to reduce blood loss.
Historically, the therapeutic actions of ergot-infested grain during pregnancy and childbirth have been documented for centuries.
Ergonovine has also been used off-label to induce coronary artery spasm for the diagnosis of Prinzmetal’s variant angina.
Ergonovine may produce adverse effects consistent with the pharmacology of the ergot alkaloids in some patients; recommended dosages and durations of treatment should not be exceeded.
Ergonovine was discovered in 1932, and was approved by the FDA in 1960.
Indications
- postpartum bleeding
- variant angina diagnosis
For the prevention and treatment of postabortal or postpartum bleeding due to uterine atony
NOTE: Severe cramping is evidence of effectiveness and may justify dosage reduction.
NOTE: Routine use of ergonovine before delivery of the placenta is not recommended because of the high uterine tone produced by the drug.
NOTE: Intravenous administration of ergonovine is recommended to be confined to emergencies such as excessive uterine bleeding.
Side Effects
- abdominal pain
- anaphylactoid reactions
- angina
- asthenia
- blurred vision
- bradycardia
- cardiac valvulopathy
- chest pain (unspecified)
- coma
- confusion
- coronary vasospasm
- diarrhea
- dysgeusia
- dyspnea
- edema
- fetal death
- hallucinations
- hypertension
- hypotension
- muscle cramps
- myalgia
- myocardial infarction
- nausea
- palpitations
- paresthesias
- peripheral vasoconstriction
- phlebitis
- pruritus
- pulmonary fibrosis
- renal tubular necrosis
- respiratory depression
- restlessness
- retinal detachment
- retroperitoneal fibrosis
- seizures
- sinus tachycardia
- spontaneous fetal abortion
- stroke
- thrombosis
- tinnitus
- tissue necrosis
- uterine contractions
- uterine rupture
- visual impairment
- vomiting
- weakness
Monitoring Parameters
- pelvic exam
Contraindications
- angina
- arteriosclerosis
- biliary tract disease
- breast-feeding
- cardiac disease
- children
- cholestasis
- coronary artery disease
- diabetes mellitus
- dysfunctional uterine bleeding
- eclampsia
- elective induction of labor
- ergot alkaloid hypersensitivity
- geriatric
- headache
- hepatic disease
- hypercholesterolemia
- hypertension
- hypocalcemia
- infants
- labor
- lactase deficiency
- migraine
- myocardial infarction
- neonates
- obesity
- peripheral vascular disease
- preeclampsia
- pregnancy
- pulmonary disease
- pulmonary fibrosis
- Raynaud’s phenomenon
- renal disease
- renal failure
- renal impairment
- retroperitoneal fibrosis
- sepsis
- stroke
- surgery
- thromboangiitis obliterans (Buerger’s disease)
- thrombophlebitis
- tobacco smoking
- valvular heart disease
Interactions
- Acebutolol
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Pseudoephedrine
- Acrivastine; Pseudoephedrine
- Almotriptan
- Amiodarone
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine; Dextroamphetamine Salts
- Aprepitant, Fosaprepitant
- Articaine; Epinephrine
- Atenolol
- Atenolol; Chlorthalidone
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Bendroflumethiazide; Nadolol
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Beta-blockers
- Betaxolol
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
- Bosentan
- Brimonidine; Timolol
- Bromocriptine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Cabergoline
- Calcium-channel blockers
- Carbetapentane; Pseudoephedrine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Pseudoephedrine
- Carboprost Tromethamine
- Carteolol
- Carvedilol
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chloroprocaine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Pseudoephedrine
- Cimetidine
- Citalopram
- Clarithromycin
- Cocaine
- Conivaptan
- Danazol
- Delavirdine
- Desloratadine; Pseudoephedrine
- Desvenlafaxine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Diazoxide
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dinoprostone, Prostaglandin E2
- Dirithromycin
- Dobutamine
- Dorzolamide; Timolol
- Duloxetine
- Elbasvir; Grazoprevir
- Eletriptan
- Enflurane
- Epinephrine
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esmolol
- Fenoldopam
- Fexofenadine; Pseudoephedrine
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluvoxamine
- Frovatriptan
- grapefruit juice
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Pseudoephedrine
- Halothane
- Hydralazine
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Pseudoephedrine
- Imatinib
- Isoproterenol
- Itraconazole
- Ketoconazole
- Labetalol
- Letermovir
- Levobetaxolol
- Levobunolol
- Levomilnacipran
- Lidocaine; Prilocaine
- Linezolid
- Lisdexamfetamine
- Loratadine; Pseudoephedrine
- Lorcaserin
- Mepivacaine
- Mepivacaine; Levonordefrin
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methylene Blue
- Metoprolol
- Metronidazole
- Miconazole
- Milnacipran
- Minoxidil
- Mirtazapine
- Nadolol
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Naratriptan
- Nebivolol
- Nebivolol; Valsartan
- Nefazodone
- Nicotine
- Nilotinib
- Nitrates
- Nitroprusside
- Norfloxacin
- Oxytocin
- Paroxetine
- Penbutolol
- Phentermine
- Phentermine; Topiramate
- Pindolol
- Posaconazole
- Prilocaine
- Prilocaine; Epinephrine
- Procaine
- Propranolol
- Protease inhibitors
- Pseudoephedrine
- Quinine
- Ranolazine
- Rizatriptan
- Rufinamide
- Serotonin norepinephrine reuptake inhibitors
- Serotonin-Receptor Agonists
- Sertraline
- Sibutramine
- Sotalol
- Sumatriptan
- Tedizolid
- Telaprevir
- Telithromycin
- Timolol
- tobacco
- Vasopressors
- Venlafaxine
- Vilazodone
- Voriconazole
- Vortioxetine
- Zafirlukast
- Zileuton
- Zolmitriptan
