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
- anaphylactoid reactions
- angina
- asthenia
- AV block
- blurred vision
- bradycardia
- chest pain (unspecified)
- coma
- confusion
- coronary vasospasm
- diaphoresis
- diarrhea
- dizziness
- dysgeusia
- dyspnea
- edema
- fetal death
- hallucinations
- headache
- hematuria
- hypertension
- hypotension
- muscle cramps
- myalgia
- myocardial infarction
- nasal congestion
- nausea
- palpitations
- paresthesias
- peripheral vasoconstriction
- phlebitis
- pruritus
- rash
- renal tubular necrosis
- respiratory depression
- restlessness
- retinal detachment
- seizures
- sinus tachycardia
- spontaneous fetal abortion
- stroke
- teratogenesis
- thrombosis
- tinnitus
- tissue necrosis
- uterine contractions
- uterine rupture
- ventricular fibrillation
- ventricular tachycardia
- 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
- 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