Methylergobrevin - instructions for use, analogs, testimonials and release forms (injections in ampoules for injection in 0.2 mg / ml solution, drops 0.25 mg / ml) of the drug for the treatment of uterine bleeding and atony of uterus in adults, children and during pregnancy . Composition

In this article, you can read the instructions for using the drug Methylergobrevin. The reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Methylergobrevin in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Methylergobrevin in the presence of existing structural analogues.Use for the treatment of uterine bleeding after childbirth or abortion and with mild labor in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Methylergobrevin - uterotonizing agent. Increases myometrium tone, helps stop uterine bleeding. The active substance of the drug acts excitantly on alpha-adrenergic receptors. The drug increases the tone of the uterus, as well as increases the frequency and amplitude of its contractions. Has a weak vasospal effect, which can trigger an increase in blood pressure. Has a depressing effect on the vasomotor center, stimulates the vagus nerve. Reduces the third period of childbirth. Reduces blood loss. It inhibits the secretion of prolactin and the production of milk.

Composition

Methylergomethrin maleate + excipients.

Pharmacokinetics

After intravenous administration, the drug acts instantly, after intramuscular injection after 2-6 minutes and 5-10 minutes after oral administration. The drug lasts about 3 hours or more after intramuscular injection and up to 2 hours after intravenous. The binding of Methylergobrevin to plasma proteins is 35%.Metabolized mainly in the liver, is excreted with feces and urine. Penetrates into breast milk.

Indications

• prevention and stopping of bleeding (metrorrhagia) caused by atony of the uterus in the postpartum period;
• the need to shorten the second period of labor with mild labor (only after the appearance of the front of the child's shoulder);
• Postoperative uterine bleeding (caesarean section, removal of fibroids, abortion);
• Lochiometer (delay of loy in the uterine cavity in the postpartum period);
• subinvolution of the uterus (absence of reverse development of the uterus after delivery);
• other abnormal bleeding from the uterus and vagina.

Forms of release

Solution for intramuscular and intravenous injection 0.2 mg / ml (injections in ampoules for injection).

Drops for ingestion 0.25 mg / ml in a 10 ml bottle.

Instructions for use and dosing regimen

Intravenous, intramuscular. Doses of Methylergobrevin are determined according to the indications.

Atonic uterine bleeding: 0.1 mg (0.5 ml) intravenously or 0.2 mg (1 ml) intramuscularly, if necessary, injections can be repeated at intervals of 2 hours.

Metrorrhagia: 0.1-0.2 mg intramuscularly or 0.1 mg intravenously.

Caesarean section: the drug is administered after fetal extraction, intravenously, 0.05-0.1 mg or intramuscularly at 0.2 mg.

Abortion: appoint after the dilatation of the cervical canal: intravenously 0.1-0.2 mg. In spontaneous abortions, intravenous administration of 0.05-0.1 mg is indicated.

Childbirth: with close supervision of the obstetrician, to reduce the second period of labor, 0.1-0.2 mg of Methylergobrevin is injected intravenously only after the appearance of the head or anterior part of the fetal arm. When administering labor during general anesthesia, the administration of 0.2 mg of Methylergobrevin is recommended. If intravenous administration of the drug is not possible, then it is administered intramuscularly at a dose of 0.2-0.4 mg.

Subinvolution of the uterus, lochiometer, postpartum hemorrhage - inside by 0.125-0.25 mg or 0.1-0.2 mg subcutaneously or intramuscularly up to 3 times a day.

Side effect

• abdominal pain (abdominal pain);
• nausea;
• vomiting;
• increased sweating;
• dizziness;
• headache;
• paresthesia (impaired sensation);
• convulsions;
• spasms of the muscles of the legs;
• changes in taste;
• stroke;
• noise in ears;
• increased blood pressure;
• chest pain;
• angina (manifestation of ischemic heart disease);
• bradycardia or tachycardia (irregular heartbeat rhythm);
• myocardial infarction (acute violation of blood supply to the heart muscle);
• spasm of peripheral vessels;
• decreased milk secretion;
• allergic reactions (skin rash);
• anaphylactic shock;
• nasal congestion;
• allergic pneumonitis;
• hematuria (blood in the urine);
• thrombophlebitis at the injection site (vein blockage);
• ergotism: with prolonged use (impaired nutrition of tissues and mental disorders).

Contraindications

• hypersensitivity to ergot alkaloids;
• severe hypertension (high blood pressure);
• occlusive vascular disease;
• sepsis, toxemia (getting into the blood of microbes and their toxins);
• pregnancy;
• the first period of childbirth;
• the second period of labor before the appearance of the fetal head (tonic contraction of the uterus musculature can cause fetal asphyxia);
• nephropathy (kidney damage);
• lactation period.

With caution

• cardiac ischemia;
• stenosis of the mitral valve;
• the need for manual removal of the placenta;
• renal or hepatic insufficiency.

Application in pregnancy and lactation

It is forbidden to appoint Methylergobrevin during pregnancy due to its effect on the smooth muscles of the uterus.

The active component of the drug is excreted in breast milk.If you can not avoid using the drug during lactation, you should decide on the temporary interruption of breastfeeding. Restorative breastfeeding is possible after the completion of the course of therapy Methylergobrevinom, after consulting with your doctor.

Use in children

Methylergobrevin is not intended for use in pediatrics.

special instructions

The drug should be used only in a specialized hospital, with strict medical control of blood pressure, heart rate, contractile activity of the uterus.

In the case of intravenous use, Methylergobrevin should be administered slowly, for at least 60 seconds, with simultaneous monitoring of blood pressure, since there is a risk of sudden increases in blood pressure and severe impairment of cerebral circulation.

Arterial or periarterial administration of the drug is prohibited.

Methylergobrevin is used with caution in patients with liver and kidney disease.

Patients with coronary artery disease or with the presence of risk factors for coronary artery disease (eg, smoking, obesity, diabetes,presence of high cholesterol) are more likely to develop ischemia and myocardial infarction due to metergergometrin-induced spasm.

Ampoules must be thoroughly inspected before use. In the presence of sediment in solution or a change in the color of the solution, the drug should not be used.

When applied immediately after the birth of the child (if the placenta is in the uterine cavity) may interfere with the separation of the afterbirth.

Impact on the ability to drive vehicles and manage mechanisms

In connection with the possible development of adverse reactions from the central nervous system, one should refrain from managing motor transport and working with other mechanisms at the time of treatment.

Drug Interactions

Do not simultaneously use active inhibitors of CYP 3A4 with Methylergometrin. Examples of some active CYP 3A4 inhibitors include macrolide antibiotics (eg, erythromycin, trolleandomycin, clarithromycin), HIV protease or reverse transcriptase inhibitors (eg, ritonavir, indinavir, nelfinavir, delavirdine) or azole fungicides (eg, ketoconazole, itraconazole, voriconazole).Less active inhibitors of CYP 3A4 should be used with caution (saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxamine, zileuton and clotrimazole). This list is not exhaustive and the physician should take into account the effects of CYP 3A4 other agents when used concomitantly with Methylergometrin.

Drugs (eg, nevirapine, rifampicin), which are strong inducers of CYP 3A4, in most cases reduce the pharmacological action of Methylergobrevin.

Care should be taken when using Methylergobrevin with beta-blockers. Simultaneous application with beta-blockers can enhance vasoconstrictive action of ergot alkaloids.

Methylergobrevin in combined use can increase the severity of the therapeutic effect of vasoconstrictor drugs, as well as preparations of the group of ergot alkaloids.

In the prevention and therapy of atonic uterine bleeding, the combined use of methylergobrevin and oxytocin is allowed.

The combination with dopamine is contraindicated, since it is possible to develop gangrene of the extremities.

Fluorotane, halothane, methoxyflurane reduce the sensitivity of the uterus and decrease the activity of Methylergometrine.

Methylergometrine maleate narrows the blood vessels and can unexpectedly reduce the effect of Nitroglycerin and other antianginal agents.

The simultaneous use of Methylergobrevin and Bromocriptine is not recommended.

It is forbidden to mix the solution for injection Methylergobrevin with other drugs for parenteral administration.

It is forbidden to combine the use of the drug and the use of alcoholic beverages.

Analogues of the drug Methylergobrevin

Methylergobrevin does not have structural analogs for the active substance.

Analogues for the pharmacological group (uterotonics):

• Oxytocin;
• Pabal;
• Shepherd's grass bag;
• Shepherd's bag extract liquid;
• Prostenongel;
• Remestil;
• Sigetin;
• Enzaprost F;
• Ergotamine tartrate.

Doctor's Feedbackobstetrician-gynecologist

This drug in combination with oxytocin saved more than one life. Women who repeatedly gave birth, who are especially prone to hypotension of the uterus in the postpartum period, often give out massive bleeding after the separation of the afterbirth.A few years ago, when there was no Pabal in our hospital, Metilergobrevin was used. Its advantage is instant action. Even with intramuscular injection, its effect does not wait. Of the disadvantages - a very high price, but it justifies itself. In addition to obstructive problems, we are appointed sometimes after an abortion to prevent bleeding.

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