Methylergonovine

Methylergonovine Brand Name– Methergine

What is Methylergonovine

Methylergonovine is an oral and parenteral semisynthetic derivative of ergonovine, an ergot alkaloid.

Methylergonovine and ergonovine 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.

Additionally, methylergonovine and ergonovine are less likely than other ergot alkaloids to cause ergot-related toxicity with repeated oral dosing and a limited duration of normal prescription use.

Methylergonovine is 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 were documented as early as the Middle Ages, well before the specific causative agent was known.

Methylergonovine may produce adverse effects consistent with the pharmacology of the natural ergot alkaloids in some patients; recommended dosages and durations of treatment should not be exceeded.

The FDA approved methylergonovine in 1946.

Indications

  • incomplete abortion
  • postpartum bleeding

For uterine atony unresponsive to massage, for subinvolution, or to control postabortal or postpartum bleeding, or for the treatment of incomplete abortion

Side Effects

  1. anaphylactoid reactions
  2. angina
  3. asthenia
  4. AV block
  5. blurred vision
  6. bradycardia
  7. chest pain (unspecified)
  8. coma
  9. confusion
  10. coronary vasospasm
  11. diaphoresis
  12. diarrhea
  13. dizziness
  14. dysgeusia
  15. dyspnea
  16. edema
  17. fetal death
  18. hallucinations
  19. headache
  20. hematuria
  21. hypertension
  22. hypotension
  23. muscle cramps
  24. myalgia
  25. myocardial infarction
  26. nasal congestion
  27. nausea
  28. palpitations
  29. paresthesias
  30. peripheral vasoconstriction
  31. phlebitis
  32. pruritus
  33. rash
  34. renal tubular necrosis
  35. respiratory depression
  36. restlessness
  37. retinal detachment
  38. seizures
  39. sinus tachycardia
  40. spontaneous fetal abortion
  41. stroke
  42. teratogenesis
  43. thrombosis
  44. tinnitus
  45. tissue necrosis
  46. uterine contractions
  47. uterine rupture
  48. ventricular fibrillation
  49. ventricular tachycardia
  50. visual impairment
  51. vomiting
  52. 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
  • 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
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Almotriptan
  • Amiodarone
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine; Dextroamphetamine Salts
  • Aprepitant, Fosaprepitant
  • Articaine; Epinephrine
  • Atazanavir; Cobicistat
  • 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
  • Brimonidine; Timolol
  • Bromocriptine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Cabergoline
  • 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
  • Cobicistat
  • Cocaine
  • Conivaptan
  • Danazol
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Delavirdine
  • Desloratadine; Pseudoephedrine
  • Desvenlafaxine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dinoprostone, Prostaglandin E2
  • Dirithromycin
  • Dobutamine
  • Dorzolamide; Timolol
  • Duloxetine
  • Elbasvir; Grazoprevir
  • Eletriptan
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enflurane
  • Epinephrine
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esmolol
  • Fexofenadine; Pseudoephedrine
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluvoxamine
  • Frovatriptan
  • grapefruit juice
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Pseudoephedrine
  • Halothane
  • 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
  • Mirtazapine
  • Nadolol
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Naratriptan
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Nicardipine
  • Nicotine
  • Nilotinib
  • Nitrates
  • Nitroprusside
  • Norfloxacin
  • Oxytocin
  • Paroxetine
  • Penbutolol
  • Perindopril; Amlodipine
  • 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
  • Streptogramins
  • Sumatriptan
  • Tedizolid
  • Telaprevir
  • Telithromycin
  • Timolol
  • tobacco
  • Trandolapril; Verapamil
  • Vasopressors
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Voriconazole
  • Vortioxetine
  • Zafirlukast
  • Zileuton
  • Zolmitriptan
You cannot copy content of this page