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DRUG DESCRIPTION
Metherlin (methylergonovine maleate) is a semi-synthetic ergot
alkaloid used for the prevention and control of postpartum
hemorrhage.
Active Ingredient: methylergonovine maleate, USP, 0.2 mg.
Inactive Ingredients: acacia, carnauba wax, D&C Red #7, FD&C Blue
#1, gelatin special, lactose, maleic acid, mixed parabens,
povidone, sodium benzoate, sodium hydroxide, starch, stearic acid,
sucrose, talc, and titanium dioxide.
INDICATIONS
For routine management after delivery of the placenta; postpartum
atony and hemorrhage; subinvolution. Under full obstetric
supervision, it may be given in the second stage of labor
following delivery of the anterior shoulder.
USES
This medication is used to help stop bleeding after delivery
of the placenta in childbirth. Methylergonovine maleate belongs to
a class of drugs known as ergot alkaloids. It works by increasing
the stiffness of the uterus muscles after the last stage of labor.
This effect decreases bleeding.
DOSAGE AND ADMINISTRATION
Intramuscularly
0.2 mg, after delivery of the anterior shoulder, after delivery of
the placenta, or during the puerperium. May be repeated as
required, at intervals of 2-4 hours.
Intravenously
Dosage same as intramuscular.
Orally
One tablet, 0.2 mg, 3 or 4 times daily in the puerperium for a
maximum of 1 week.
SIDE EFFECTS
The most common adverse reaction is hypertension associated in
several cases with seizure and/or headache. Hypotension has also
been reported. Nausea and vomiting have occurred occasionally.
Rarely observed reactions have included: acute myocardial
infarction, transient chest pains, arterial spasm (coronary and
peripheral), bradycardia, tachycardia, dyspnea, hematuria,
thrombophlebitis, water intoxication, hallucinations, leg cramps,
dizziness, tinnitus, nasal congestion, diarrhea, diaphoresis,
palpitation, rash, and foul taste.1
There have been rare isolated reports of anaphylaxis, without a
proven causal relationship to the drug product.
Drug Abuse And Dependence
Metherlin (methylergonovine maleate) has not been associated with
drug abuse or dependence of either a physical or psychological
nature.
WARNINGS
This drug should not be administered I.V. routinely because of the
possibility of inducing sudden hypertensive and cerebrovascular
accidents. If I.V. administration is considered essential as a
lifesaving measure, Metherlin (methylergonovine maleate) should be
given slowly over a period of no less than 60 seconds with careful
monitoring of blood pressure. Intra-arterial or periarterial
injection should be strictly avoided.
PRECAUTIONS
Before taking methylergonovine maleate, tell your doctor or
pharmacist if you are allergic to it; or to similar ergot
alkaloids (e.g., ergonovine); or if you have any other allergies.
This medication should not be used if you have certain medical
conditions. Before using this medicine, consult your doctor or
pharmacist if you have: high blood pressure, a certain
complication of pregnancy (toxemia).
Before using this medication, tell your doctor or pharmacist your
medical history, especially of: heart disease (e.g., venoatrial
shunt, mitral valve stenosis), other complications during
pregnancy (e.g., pre-eclampsia, eclampsia), a serious blood
infection (sepsis), blood vessel problems (e.g., Raynaud's
phenomenon, obliterative vascular disease), kidney problems, liver
problems.
This drug may make you dizzy or drowsy. Use caution while driving,
using machinery, or doing any activity that requires alertness.
Limit or avoid alcoholic beverages.
STORAGE
Store at room temperature below 77 degrees F (25 degrees C) away
from light and moisture. Do not store in the bathroom. Keep all
medicines away from children
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