Pharm

Ergonovine

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Ergonovine, Ergometrine, Ergotrate, Ergostat, Syntometrine

  • Indications
  1. Postpartum Hemorrhage
    1. After delivery of the anterior Shoulder and placenta
  2. Uterine Hemorrhage
    1. Dilation and Curettage associated Hemorrhage
    2. Early Pregnancy Loss associated Hemorrhage
    3. Uterine Inversion associated Hemorrhage (following Uterus replacement)
  • Mechanism
  1. Ergonovine is used worldwide as a uterotonic agent in Postpartum Hemorrhage
    1. Methylergonovine (Methergine) is an Ergonovine homolog, with an added methyl group
    2. Methylergonovine is used in the U.S. instead of Ergonovine
    3. Ergonovine has a long history of use and was originally extracted from rye ergot fungus
      1. It can also be synthesized from Lysergic Acid
      2. Ergonovine can be used to synthesize Lysergic Acid Diethylamide (LSD)
  2. Ergonovine is an ergot alkaloid
    1. Increases uterine tone and contraction
    2. Increases vascular smooth Muscle Contraction (Vasoconstriction)
  3. Ergonovine has complex interactions at multiple receptors
    1. Adrenergic Receptors
    2. Dopamine receptors
    3. Tryptamine receptors
    4. Serotonin receptors
  4. Ergonovine also decreases Prolactin levels
    1. May decrease Lactation
  • Dosing
  1. See other references
  • Adverse Effects
  1. Similar to Methylergonovine
  2. Cardiovascular
    1. Cardiac Arrhythmia
    2. Hypertension
      1. Paradoxical Hypotension has also been reported
  3. Neurologic
    1. Seizure
    2. Cerebrovascular Accident
  4. Gynecologic
    1. Abdominal Pain or cramping
    2. Nausea or Vomiting
  • Safety
  1. Avoid in Lactation
  2. Contraindicated in pregnancy (except postpartum or after pregnancy loss)
  • Resources
  1. Olson (2020) Clinical Pharmacology, Medmaster, Miami, Fl, p. 154
  2. Ergometrine (Wikipedia)
    1. https://en.wikipedia.org/wiki/Ergometrine