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Methergin tablet injection contains very useful medicine which known as Methylergometrine. Methylergometrine belongs to the ergoline and lysergamide drugs class and only used an oxytocic for the treatment of migraine. Basically the medicine used for the prevention and the treatment of the post partum hemorrhage.

What Is Methylergometrine And What It Used For?

Mainly Methylergometrine most people known as partial agonist and antagonist of the serotonin and dopamine drugs or a-adrenergic receptor which also known with some other names like

• Methylergonovine
• Methylergobasin
• Methylergobasine

It generally belong from the drug class of ergoline and lysergamide medications. Mainly it shows the psychedelic effects which used for the treatment of oxytocic in obstetrics as well as for cure of migraine. Moreover, the medicine first discovered during studies in USA in year 1985. However they first approved to use it in medicine in the year 2000.

Tablets Injection Of Methergin Composition Formula Ingredients

• Methergin Tablets : Contains Methylergometrine Maleate = 0.125 MG
• Methergin Injection: Contains Methylergometrine Maleate = 0.2 mg/ml

Methergine Tablet Injections Uses & Indications

• Active management of the third stage of labor ( as a means to promote separation of the placenta and to reduce blood loss).
• Methergine used for the treatment of uterine atony, hemorrhage occurring during or after the third stage of labor, in association with cesarean section or following
• For the treatment of sub involution of the uterus, lochiometra, puerperal bleeding.

Methergine Tablets Injection Dosage And Administration

Active management of the third stage of labor

Intramuscular injection (i.m.) is the recommended route of administration. However, when administered (i.v.) the Methergine Dosage must administered slowly over a period of no less than 60 seconds.

Meanwhile, the recommended dose: 1 ml (0.2 mg) i.m. or 0.5 to 1 ml (0.1 to 0.2 mg) by slow i.v. administration following delivery of the anterior shoulder or, at the latest, immediately after delivery of the child. Furthermore, expulsion of the placenta, usually separated by the first strong contraction following the medicine should manually assisted by applying fundal pressure.

For delivery under general anesthesia, the recommended Methergin dose is 1 mL
(0.2 mg) by slow i.v. injection

Treatment of Uterine atony/hemorrhage

I.m. injection recommended route of administration. when administered intravenously (i.v.) the dose must be administered slowly over a period of no less than 60 seconds.

The recommended dosage of syrup is: 1 mL (0.2 mg) i.m. or 0.5 to 1 mL (0.1 to 0.2 mg ) slow i.v. administration . The dose may be repeated every 2 to 4 hours, if necessary, up to five doses within 24 hours .

Treatment of subinvolution, Lochiometra, Puerperal Bleeding

The recommended dosage of the tablets syrup is : 1 or 2 tablets (0.125 to 0.25 mg ) orally, or 0.5 to mL (0.1 to 0.2 mg) s.c. or i.m, up to 3 times daily and usually for up to 5 days.

Methergine Injection Tablets Special populations

Renal Impairment /Hepatic Impairment

Consequently, the caution should exercised in the presence of impaired hepatic or renal function .

Methergine Contraindications

• Pregnancy;
• First stage of labor; second stage of labor before delivery of the anterior shoulder (Methergine must not be used for induction or enhancement of labor);
• Severe hypertension;
• Pre-eclampsia and eclampsia;
• occlusive vascular disease (including ischemic heart disease);
• Sepsis;
• Known hypersensitivity to methy/lergometrine, to other ergot alkaloids or o any excipients of the medicine.

Methergine Tablets Injections Warnings And Precautions

General Recommended On Administration

In breech presentation and other abnormal presentations methergin should not be given before delivery of the child is completed, and in multiple birth not before the last child has been delivered.

Meanwhile, Active management of the third stage of labor requires obstetric supervision.

On the other hand, Intramuscular injection is the recommended route of administration. Intravenous injections must be given slowly over a period of no less than 60 intra-or peri arterial injection must be avoided.

Babies-feeding

However, due to the possible side effects for the child and the reduction of the milk, It is not recommended for use during baby-feeding. women should not baby-feed during treatment with the tablets/syrup and at least 12 hours after administration of the last dose. Malik secreted during this period should be discarded.

Hypertendion And Impaired Hepatic Or Renal Function

Firstly, Caution should be exercised in the presence of milk or moderate hypertension(severe hypertension is a contraindication) or impaired hepatic or renal function.

Coronary Artery Disease

Meanwhile, Patients with coronary artery disease or with risk factors for coronary artery disease (e.g. smoking, obesity, diabetes, high cholesterol) may be more susceptible to developing myocardial ischemia and infarction associated with ,methylergometrine-induced vasospasm.

Medication Errors

Most importantly, there are reports of some accidental administration of the medicine to the newborn infants. In these accidental neonatal cases, symptoms such as respiratory depression, convulsions, cyanosis, oliguria, have been reported. Furthermore, Encephalopathy has been reported in infants presenting with signs and symptoms such as irritability, agitation and lethargy. Treatment should be symptomatic, in severe cases respiratory and cardiovascular support have been required. Fatal cases have been reported in the absence of adequate treatment.

Methergine Drug Interactions

Ergot alkoxides are substrates of CYP3A4. the concomitant use of methergine with potent CYP3A4 inhibitors such as macrolide antibiotics (e.g. troleandomycin, erythromycin, clanthromycin), HLy protease or reverse transcriptase inhibitors (e.g. ritonavir, indinavir,delavirdine), Orazole anti-fungals(vasospasm and ischemia of the extremities and other tissues).

The concomitant use of the medication with bromocriptine in the puerperium, or with prostaglandins not recommended.

Caution required when using Methergines with drugs with less potent CYP3A4 inhibitors (e.g. cimetidine, delavirdine, grapefruit juice, quinupristin dalfopristin). Or with drugs with vasoconstrictor/vasopressor effects such as triptans (5H1B/1D receptor agonists), sympathominetics, other ergot alkaloids orbeta-blockers.

Driving And Using Machines

Methylergometrine may cause dizziness and convulsions. Therefore, caution must exercised to the patients when driving or operating machines.

Methergine Medicine Adverse Medicine Reactions

Adverse reactions listed by MEDDRA system organ class. And in each system organ class, the medicine reactions ranked by the frequency, with the most frequent first.

Within each frequency group, the drug adverse reactions ranked in order of decreasing seriousness. In addition, The corresponding frequency category for each adverse drug reaction is based on the following convention

• Very common (>/- 1/10)
• Common (>/- 1/100, < 1/10)
• Uncommon (>/- 1/1000, < 1/100)
• Rare (>/- 1 / 10,000, < 1/1,000)
• Very rare(<1/10,000).

Methergine Side Effects

Immune System Disorders

Very Rare Anaphlactic reactions.

Nervous System Disorders

Common Headache.

Uncommon dizziness, convulsion.

Very rare Hallucinations.

Ear And labyrinth Disorders

Very rare tinnitus.

Cardiac Disorders

Uncommon chest pain.

Rare Bradycardia, rachycardia, palpitations.

Very rare Myocardial infarction, arteriospasm coronary.

Vascular Disorders

Common hypertension.

Uncommon hypotension.

Rare vasoconstrication, vasospasm, arterial spasm.

Very rare thrombophlebitis.

Respiratory, Thoracic And Mediastinal Disorders

very rare Nasal congestion.

Gastrointestinal disorders

Uncommon vomiting. nausea.

Very rare diarrhoea.

Skin And Subcutaneous Tissue Disorders

Very rare Muscle spams.

Methergine Side Effects For Pregnancy, Puerperium And Perinatal Conditions

Common Abdominal pain (caused by uterine contractions).

Adverse Drug reactions from post-marketing spontaneous reports and literature cases(frequency mot know)

The following adverse drug reactions have derived from post-marketing experience with with methergine via spontarneous case reported. Since these reactions reported voluntarily from a population of uncertain size. Therefore, it not possible to reliably estimate their frequency. Which therefore categorized as not known. adverse drug reactions listed according to system organ classes in in meddra. within each system organ class, ADRs presented in order of decreasing seriousness.

Nervous System Disorders

Cerebrovascular accident, paraesthesia.

Cardiac disorders

Ventricular fibrillation, ventricular tachycardia, angina pectoris, atrioventricular block.

Women of child-bearing potential, pregnancy, baby Feeding and Fertility

Women of child bearing potential

Not applicable for lethergin due to the targeted indications.

Methergine In Pregnancy

The use of methergine in pregnancy contraindicated because of its potent uterotonic activity.

baby-feeding

Firstly, Methergines has reported to reduce milk secretion and to excreted in the milk. However, There have isolated reported of intoxication in baby-fed infants whose mothers receiving the drug for several days. One or more of the following symptoms observed (and disappeared upon withdrawal of the medication): elevated blood pressure , bradycardia or tachycardia, vomiting , diarrhea, restlessness and convulsions.

In view of the possible side effects for the child and the reduction of the milk yield. Therefore, this tablet not recommended for use during baby-feeding. So, Women should discarded.

Fertility

Not applicable for methergin tablet due to the targeted indications.

Methergine Tablet Injection Overdosage

Symptoms

Furthermore, Nausea; vomiting; hypertension or hypotension;numbness; tingling and pain in the extremities; respiratory depression; convulsions; coma may be the symptoms of Overdosage.

Treatment

Therefore, Elimination of orally given medicine by administration of high doses of activated charcoal.

Consequently, Symptomatic treatment under close monitoring of the cardiovascular and the respiratory system.

However, If sedation required, benzodiazepines may used.

In case of severe arteriospasm, vasodilators should be provided, e.g. sodium nitroprusside, phentolamine or dihydralazine. In the event of coronary constriction, appropriate anti-anginal treatment should be provided (e.g. nitrates).

Methergin Tablet Injections Storage Instructions

Firstly, you must remember to keep your medicines out of the reach of your children. On the other hand, protect the product from direct sunlight and heat. Meanwhile, store the medicine below 30 C temperature.