Ergonovine maleate

Section 1.1

Midwives may independently prescribe, order and administer this drug.

An alkaloid from ergot stimulates contractions and acts systemically on the upper and lower segments of the uterine smooth muscle to increase strength, duration, and frequency of uterine contractions.

Indications and Clinical Use:

Ergonovine maleate is an effective agent for the prevention and treatment of PPH. It is used as a second line medication for the treatment of postpartum uterine atony and/or for postpartum hemorrhage uncontrolled by the use of oxytocin.

Contraindications:

Ergonovine maleate is contraindicated in the presence of: hypertension, pre eclampsia, hypersensitivity to ergonovine maleate or any ingredient in the formulation, as well as for those receiving treatment for HIV which includes protease inhibitors or non-nucleoside reverse transcriptase inhibitors.

Warnings and Precautions:

Use with caution in patients with cardiovascular disease, hepatic impairment, renal impairment. Ergonovine is considered as a second choice to oxytocin due to greater risk of adverse effects and of the an increased risk of retained placenta.

Must be refrigerated (2 to 8˚C). Protect from light. (Check specific manufacturer product monograph for most accurate storage conditions.)

Pregnancy:

Contraindicated

Lactation:

Category L3 – Limited Data – Probably Compatible

Adverse Reactions:

Hypertension, seizures, headache, hypotension, nausea and vomiting.

Dosage and Administration:

Supplied as 0.25 mg/mL. Second line medication for the treatment of postpartum uterine atony and/or for postpartum hemorrhage uncontrolled by the use of oxytocin:
0.25 mg IM or IV (slowly) once, if further doses are required, repeat every 2-4 hours.
Maximum cumulative dose of 5 doses.

Onset of Action:

2-7 minutes IM
>1 minute IV

Half-life:

0.52 hours