Drugs List

Therapeutic Indications

Uses

Labour - management during third stage
Post partum haemorrhage (high risk) - prevention

Contraindications

Sepsis
Breastfeeding
Eclampsia
First and second stages of labour
Induction of labour
Pre-eclampsia
Pregnancy
Severe cardiac disorder
Severe hepatic impairment
Severe hypertension
Severe renal impairment
Vascular disorder

Precautions and Warnings

Cardiac disorder
Coronary arteriosclerosis
Mild hepatic impairment
Mild hypertension
Mild renal impairment
Multiple pregnancy
Porphyria
Raynaud's syndrome

Treatment to be prescribed under the supervision of a specialist
If uterine bleeding persists after administration, investigate cause
Advise patient grapefruit products may increase plasma level

Pregnancy and Lactation

Pregnancy

Ergometrine is contraindicated in pregnancy. Use of ergometrine is strictly restricted to the third stage of labour.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Ergometrine is contraindicated in breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal pain
Angina
Arterial spasm
Bradycardia
Cardiac arrhythmias
Chest pain
Dizziness
Dyspnoea
Headache
Hypertension (transient)
Myocardial infarction
Nausea
Palpitations
Pulmonary oedema
Rash
Tinnitus
Vasoconstriction
Vomiting

Presentation

Solution for injection containing ergometrine

Drugs List

Therapeutic Indications

Uses

Labour - management during third stage
Post partum haemorrhage (high risk) - prevention

Dosage

Adults

Contraindications

Sepsis
Breastfeeding
Eclampsia
First and second stages of labour
Induction of labour
Pre-eclampsia
Pregnancy
Severe cardiac disorder
Severe hepatic impairment
Severe hypertension
Severe renal impairment
Vascular disorder

Precautions and Warnings

Cardiac disorder
Coronary arteriosclerosis
Mild hepatic impairment
Mild hypertension
Mild renal impairment
Multiple pregnancy
Porphyria
Raynaud's syndrome

Treatment to be prescribed under the supervision of a specialist
If uterine bleeding persists after administration, investigate cause
Advise patient grapefruit products may increase plasma level

Pregnancy and Lactation

Pregnancy

Ergometrine is contraindicated in pregnancy. Use of ergometrine is strictly restricted to the third stage of labour.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Ergometrine is contraindicated in breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal pain
Angina
Arterial spasm
Bradycardia
Cardiac arrhythmias
Chest pain
Dizziness
Dyspnoea
Headache
Hypertension (transient)
Myocardial infarction
Nausea
Palpitations
Pulmonary oedema
Rash
Tinnitus
Vasoconstriction
Vomiting

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: July 2014

Reference Sources

Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press https://www.medicinescomplete.com [Accessed on May 6, 2014].

Summary of Product Characteristics: Ergometrine Injection BP 0.05% w/v (hameln). Hameln pharmaceuticals Ltd. Revised July 2007.