Adult: For the management of uterine atony, haemorrhage and subinvolution of the uterus after placental delivery; control of uterine haemorrhage after delivery of the anterior shoulder in the 2nd stage of labour: 0.2 mg via IM or slow IV (not <60 seconds) inj after anterior shoulder or placental delivery, or during puerperium; may repeat every 2-4 hours as necessary.
Oral Postpartum haemorrhage
Adult: For the management of uterine atony, haemorrhage and subinvolution of the uterus after placental delivery; control of uterine haemorrhage after delivery of the anterior shoulder in the 2nd stage of labour: 0.2 mg 3-4 times daily in the puerperium for up to 1 week.
What are the brands available for Methylergometrine in Philippines?
Patient with sepsis, obliterative vascular disease; CAD or at risk for CAD (e.g. high cholesterol, obesity, diabetes, smoking). Use during the 2nd stage of labour. IV administration should only be considered during life-threatening situations and not recommended for routine use due to the risk of sudden hypertensive and cerebrovascular accidents; if considered, administer via slow IV inj (not <60 seconds) with careful monitoring of blood pressure. Avoid intra-arterial or peri-arterial inj. Renal and hepatic impairment. Lactation.
Adverse Reactions
Significant: Myocardial ischaemia and infarction (particularly in patients with or at risk for CAD); hypertension, hypotension; ergotism (prolonged use). Cardiac disorders: Palpitations, tachycardia. Ear and labyrinth disorders: Tinnitus. Gastrointestinal disorders: Abdominal pain, nausea, vomiting, diarrhoea, unpleasant taste. Musculoskeletal and connective tissue disorders: Leg cramps. Nervous system disorders: Dizziness, headache. Psychiatric disorders: Hallucinations. Renal and urinary disorders: Haematuria. Respiratory, thoracic and mediastinal disorders: Dyspnoea, nasal congestion. Skin and subcutaneous tissue disorders: Skin rash, diaphoresis. Vascular disorders: Thrombophlebitis, vasoconstriction, vasospasm.
Breastfeeding is not recommended during treatment and for 12 hours after the last dose.
Monitoring Parameters
Monitor blood pressure and heart rate. Assess for signs of vaginal bleeding post-administration and CNS changes (e.g. headache, dizziness, hallucinations, seizures).
Overdosage
Symptoms: Nausea, vomiting, abdominal pain, oliguria, tingling of the extremities, numbness, rise or fall in blood pressure, respiratory depression, hypothermia, convulsions, and coma. Management: Symptomatic and supportive treatment. Remove offending drug by inducing emesis, gastric lavage, catharsis, or supportive diuresis. Maintain adequate pulmonary ventilation, especially if convulsions or coma develop. Administer standard anticonvulsant agents to control convulsions. Correct hypotension with pressor drugs. Treat peripheral vasospasm by applying warmth to the extremities as necessary.
Drug Interactions
May decrease the serum concentration with strong CYP3A4 inducers (e.g. rifampicin, nevirapine). May enhance vasoconstricting effects with β-blockers. Concomitant use with certain ergot alkaloid drugs (e.g. dihydroergotamine, ergotamine) and potent CYP3A4 inhibitors (e.g. erythromycin, clarithromycin, ritonavir, indinavir, delavirdine, ketoconazole, itraconazole, voriconazole) may cause vasospasm resulting in cerebral ischaemia and/or ischaemia of the extremities. May diminish the oxytocic potency with anaesthetics (e.g. halothane, methoxyflurane). Reduced therapeutic effect of glyceryl trinitrate and other antianginal agents.
Food Interaction
May increase serum concentration with grapefruit juice.
Action
Description: Mechanism of Action: Methylergometrine is an amine ergot alkaloid which directly stimulates uterine smooth muscle contractions. It increases the tone, rate, and amplitude of uterine contractions, resulting in a rapid and sustained tetanic uterotonic effect that shortens the 3rd stage of labour and reduces uterine bleeding. Synonym(s): Methylergonovine. Onset: Oral: 5-10 minutes. IM: 2-5 minutes. IV: Immediate. Duration: Approx 3 hours. Pharmacokinetics: Absorption: Rapidly absorbed. Bioavailability: 60% (oral); 78% (IM). Time to peak plasma concentration: 1.12 ± 0.82 hours (oral); 0.41 ± 0.21 hours (IM). Distribution: Enters breast milk. Volume of distribution: 56.1 ± 17 L (IM). Metabolism: Undergoes extensive first-pass hepatic metabolism. Excretion: Via urine and faeces. Elimination half-life: Approx 2-3 hours.
Chemical Structure
Methylergometrine Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 8226, Methylergonovine. https://pubchem.ncbi.nlm.nih.gov/compound/Methylergometrine. Accessed July 29, 2025.
Storage
Tab: Store between 15-30°C. IV/IM inj: Store between 2-8°C. Protect from light.
G02AB01 - methylergometrine ; Belongs to the class of ergot alkaloids. Used to induce abortion or augment labour and to minimize blood loss from the placental site.
References
Brayfield A, Cadart C (eds). Methylergometrine Maleate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/07/2025.Demergin Injection (Pahang Pharmacy Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 07/07/2025.Ergonovine Maleate, Methylergonovine Maleate. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 07/07/2025.Methylergometrine [Methylergonovine]. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 07/07/2025.Methylergonovine Maleate Injection, Solution (Pharmacist Pharmaceutical, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 07/07/2025.Methylergonovine Tablet (Amneal Pharmaceuticals NY LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 07/07/2025.Methylergonovine. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 07/07/2025.
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