Methylergonovine

Administration

• Type: Uterotonic
• Dosage Forms: Tablet, injection
• Routes of Administration: IM, IV
• Common Trade Names: Methergine

Adult Dosing

Postpartum hemorrhage

• 0.2 mg IV q2-4h prn

Pediatric Dosing

• Pediatric dosing not applicable or safety has not been established in pediatric patients.

Special Populations

Pregnancy Rating

• Contraindicated during pregnancy
• No known risk of teratogenicity
• Risk of fetal hypoxia based on mechanism of action

Lactation risk

• Avoid breastfeeding during treatment and 12 hours after discontinuing
• Risk for infant vomiting, diarrhea, bradycardia, tachycardia, and seizures

Renal Dosing

• Adult: Caution advised in impairment
• Pediatric: N/A

Hepatic Dosing

• Adult: Caution advised in impairment
• Pediatric: N/A

Contraindications

• Allergy to class/drug
• Intra or periarterial administration
• Pregnancy
• Breastfeeding up to 12 hours after d/c
• HTN
• Toxemia

Adverse Reactions

Serious

• Seizure
• HTN, MI, vasospasm, arterial spasm
• Arrhythmia, AV block
• Thrombophlebitis
• Stroke
• Hallucinations

Common

• HTN
• Headache, abdominal pain, nausea, vomiting

Pharmacology

• Half-life: 3.4h
• Metabolism: Liver
• Excretion: Urine (<5% unchanged), feces

Mechanism of Action

• Increases uterine contraction force and frequency

See Also

• Postpartum hemorrhage