RESURRECTION UNIVERSITY MEDICATION CARD

CLASSIFICATION

Ergot alkaloid, oxytocic agents, uterine stimulant.

DRUG NAME

Methylergonovine (Brand: Methergine)

MECHANISM OF ACTION

Stimulates uterine, vascular, and smooth muscle, as a result, causing contractions,

decreases bleeding, arterial vasoconstriction.

THERAPEUTIC USE

Increase rate and intensity of contraction to aid and shorten the third stage of labor with
extreme caution (push out the placenta).
Reduces blood loss.

CONTRAINDICATIONS

Should not use to induce labor due to fetal harm (only use after birth).
Breastfeeding.
Hypertension, coronary artery disease, concurrent use of CYP3A4 inhibitors (grapefruit
juice).

DOSAGES AND ROUTES

Oral tablets: 200 mcg TID or QID for 7 days.

Injection: 200 mcg/ml. Give IV or IM 200 mcg q2-4h for 1-5 doses max.

ADVERSE EFFECTS

CNS: STROKE, dizziness, headache.

Ears: tinnitus.
Resp: dyspnea.
CV: HYPERTENSION, arrhythmias, AV block, chest pain, palpitations.
GI: nausea, vomiting.
GU: cramps.
Derm: diaphoresis.
Neuro: paresthesia (pins and needles).

INTERACTIONS

Smoking and other vasopressors (dopamine, epinephrine) may cause excessive

vasoconstriction.
Grapefruit juice, erythromycin, clarithromycin (CYP3A$ inhibitors) may increase the drug
concentration and therefor, increase risk of ischemia.

NURSING CONSIDERATIONS
RESURRECTION UNIVERSITY MEDICATION CARD

ASSESSMENT
BP, pulse, character, and amount of vaginal bleeding. Watch for indications of hemorrhage
Assess uterine relaxation, observe for severe cramping.
Ergot toxicity: tinnitus, hypertension, palpitations, chest pain, nausea, vomiting, weakness,
cold, numb extremities.

PATIENT PROBLEM

Post-partum or post-labor hemorrhage, subinvolution (uterine muscle loses tone, not return
to regular size).

IMPLEMENTATION

DO NOT use to induce labor.

IV administration is used for emergencies only. Oral and IM routes are preferred.
Do not exceed dosage limits.

PATIENT/FAMILY EDUCATION

Instruct patient to take medication as directed, do not skip or double up on missed doses. If
a dose is missed, exclude it, and return to regular dose schedule
Do not breast feed during treatment and for 12 hours after the last dose.
Advise patient that medication may cause menstrual-like cramp.
Do not smoke or use nicotine products.
Avoid grapefruit juice.

EVALUATION

Produce contractions that maintain uterine tone (helps deliver placenta) and prevent
postpartum hemorrhage.