Ergonovine (Ergometrine)
- Atc Codes:G02AB03
- CAS Codes:129-51-1#60-79-7
- PHARMGKB ID:129-51-1#60-79-7
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Greece: Ergovin, Mitrotan, Novergo; Ireland: Ergometrine; Italy: Ergome M; Romania: Ergometrina; Slovenia: Ergometrin; UK: Ergometrine.
North America
Canada: Ergonovine.
Latin America
Argentina: Ergonovina, Evina, Metrergina; Mexico: Ergotrate.
Asia
Japan: Ergometrine.
Drug combinations
Ergonovine and Oxytocin
Chemistry
Ergonovine Maleate: C~19~H~23~N~3~O~2~ C~4~H~4~O~4~. Mw: 441.48. (1) Ergoline-8-carboxamide, 9,10-didehydro-N-(2-hydroxy-1-methylethyl)-6-methyl-, [8β(S)]-, (Z)-2-butenedioate (1:1); (2) 9,10-Didehydro-N-[(S)-2-hydroxy-1-methylethyl]-6-methylergoline-8β-carboxamide maleate (1:1). CAS-129-51-1; CAS-60-79-7 (ergonovine).
Pharmacologic Category
Oxytocics; Ergot Derivative. (ATC-Code: G02AB03).
Mechanism of action
Affects primarily uterine smooth muscles producing sustained contractions and thereby shortens the third stage of labor.
Therapeutic use
Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution.
Pregnancy and lactiation implications
Causes hyperstimulation of the uterus and may cause uterine tetany, decreased uteroplacental blood flow, uterine rupture, cervical and perineal lacerations, amniotic fluid embolism, and possible trauma to the infant. Used in the 3^rd^ stage of labor for the prevention and treatment of postpartum hemorrhage. Contraindicated during pregnancy.
Unlabeled use
Diagnostically to identify Prinzmetal’s angina.
Contraindications
Hypersensitivity to ergonovine or any component of the formulation. Ergot alkaloids contraindicated with potent inhibitors of CYP3A4 (protease inhibitors, azole antifungals, and some macrolide antibiotics). Induction of labor, threatened spontaneous abortion, pregnancy.
Warnings and precautions
Ergot alkaloids associated with fibrotic valve thickening (e.g. aortic, mitral, tricuspid); usually associated with long-term, chronic use. Use may result in ergotism (intense vasoconstriction) resulting in peripheral vascular ischemia and possible gangrene. Rare cases of pleural and/or retroperitoneal fibrosis reported with prolonged daily use. Use with caution in cardiovascular disease (e.g. hypertension), hepatic impairment, renal impairment, sepsis, or in obliterative vascular disease. Use with extreme caution or avoid use in the elderly (due to vasoconstrictive properties and cardiovascular adverse effects). Concomitant use with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics) and ergot alkaloids associated with acute ergot toxicity (ergotism); certain ergot alkaloids (e.g. ergotamine and dihydroergotamine) contraindicated by manufacturer. Use with extreme caution when administering intravenously (risk of inducing sudden hypertensive and cerebrovascular accidents).