Methylergonovine (Oral)

Methylergonovine is an ergot alkaloid that acts on the smooth muscles of the uterus to prevent bleeding.

Overview

After giving birth it is possible that the uterus will bleed. The medication Methylergonovine is used to prevent and control such bleeding from the uterus. It is an ergot alkaloid medication that acts directly on the smooth muscles of the uterus to prevent bleeding after giving birth.

Methylergonovine is available only with a prescription and is administered as Methergine tablets.

Do not use this medication before childbirth as harm will be caused to the unborn baby.

Condition treated

  • Uterus bleeding

Type Of Medicine

  • Ergot Alkaloid

Side Effects

In addition to the needed effects of Methylergonovine, other unwanted side effects may also occur. While not all of these side effects will occur in any patient, where they do the patient may need to seek immediate medical attention.

You should immediately check with your doctor if you experience any of the following side effects from the use of Methylergonovine:

Occurring more commonly:

  • Increased blood pressure
  • Headache
  • Abdominal pain

Occurring only rarely:

  • Vomiting
  • Sweating
  • Slow or fast heartbeat
  • Skin rash
  • Puffy or swollen face, lips or tongue
  • Pain, tenderness, or swelling of the foot or leg
  • Pain or discomfort in the arms, jaw, back, or neck
  • Lightheadedness, dizziness, or fainting
  • Hives
  • Fast, pounding, or irregular heartbeat or pulse
  • Dizziness
  • Difficulty with swallowing
  • Difficult or labored breathing
  • Chest pain or discomfort
  • Change in skin color
  • Blood in the urine

Frequency of incidence not known:

  • Weakness in the arm or leg on one side of the body
  • Tingling feelings
  • Temporary blindness
  • Slurred speech
  • Severe or sudden headache
  • Seizures
  • Prickling
  • "pins and needles"
  • Numbness
  • Lightheadedness
  • Itching
  • Inability to speak
  • Faintness
  • Fainting
  • Dizziness
  • Crawling
  • Confusion
  • Burning

Certain other side effects can also occur that are usually milder and do not require you to seek medical attention. These side effects do not usually indicate any further medical problems that may be occurring either. If these side effects are ongoing or do become bothersome, however, then you should seek advice from your healthcare professional:

Occurring only rarely:

  • Stuffy nose
  • Nausea
  • Increased sweating
  • Foul taste
  • Diarrhea
  • Cramps in the legs
  • Continuous unexplained noise in the ears

Some other side effects can also occur from the use of Methylergonovine that have not been listed herein. If you experience any other side effects from use then you should seek advice from your doctor right away.

Dosage

This medication should only ever be used exactly as you have been directed to take it by your doctor. You should not take more of this medication or use it more often than you have been ordered to and you should not take it for longer than necessary. You may experience greater side effects with increased use.

You should not consume grapefruit or grapefruit juice with this medication. Doing so may increase the amount of medication absorbed into the body and will increase the side effects experienced.

The dose of this medication will be different for each patient. You should follow the orders given to you and the information on the medication. If your dose is different to the information below you should still follow the instructions given by your doctor. The amount of medication you take will vary depending on a range of factors including previous use of the injected form of this medication, weight, and other medical conditions. The following information should be used only as a guideline and should not ever be used to adjust your dose of medication:

Women experiencing bleeding following childbirth should be treated with 0.2mg 3-4 times daily. Use should continue for up to 1 week. Dosing changes may be made by the doctor as required.

If you miss a dose of this medication you should take it as soon as possible. If you are close to your next dose being due, however, then you should skip the dose and return to your normal schedule. Do not ever take a double dose to make up for a missed dose and do not take it for longer than prescribed.

Interactions

Some medications should not be used together because they can interact with one another in the body. This can cause unintended complications to occur that can be very serious. In the most severe cases such interactions can cause severe medical problems. In other cases the risk of certain side effects occurring may be increased or the medications may prevent one another from working.

In order to avoid drug interactions occurring it is important that you inform your doctor of all other medications you are taking whether they are prescribed medications or medications purchased over the counter. For use of Methylergonovine it is especially important that you inform your doctor if you are taking any of the following medications:

The use of Methylergonovine with the following treatments is not recommended. Your doctor may decide not to prescribe this treatment or may stop use of another medication:

  • Zolmitriptan
  • Voriconazole
  • Troleandomycin
  • Tipranavir
  • Telaprevir
  • Sumatriptan
  • Spiramycin
  • Saquinavir
  • Roxithromycin
  • Rokitamycin
  • Rizatriptan
  • Ritonavir
  • Posaconazole
  • Nelfinavir
  • Nefazodone
  • Naratriptan
  • Miokamycin
  • Mepartricin
  • Lopinavir
  • Ketoconazole
  • Josamycin
  • Itraconazole
  • Indinavir
  • Frovatriptan
  • Fosamprenavir
  • Erythromycin
  • Eletriptan
  • Dirithromycin
  • Delavirdine
  • Darunavir
  • Cobicistat
  • Clarithromycin
  • Boceprevir
  • Azithromycin
  • Atazanavir
  • Amprenavir
  • Almotriptan

The following medications are also not normally recommended for use with Methylergonovine. In some cases, however, these medications may be required for use together. In this case the doctor may prescribe both with adjusted dosages:

  • Telithromycin
  • Propatyl Nitrate
  • Fluvoxamine
  • Fluconazole

Interactions with other medications can also occur. Ensure that your doctor is fully aware of all medications you are taking before you begin use of Methylergonovine.

Certain medications should also not be used around the time of consuming certain foods and drinks as interactions can occur. The use of alcohol and tobacco can also effect other medications. With Methylergonovine it is important that you avoid the consumption of both grapefruit and grapefruit juice around dosing and for the period of use. This is because consumption may increase the amount of medication that is absorbed into the body.

Other medical problems suffered by the patient may also limit the use of certain medications. This is because some medications can be worsened by medications and others may increase the side effects suffered. For the use of Methylergonovine it is especially important that your doctor knows if you are suffering from any of the following conditions

These conditions can increase the risk of serious side effects:

  • Coronary artery disease
  • Diabetes
  • Hypercholesterolemia

Patients with the following conditions should not be treated with Methylergonovine:

  • Hypertension
  • Toxemia

These conditions may increase the effects of Methylergonovine in the body because it will be removed less quickly from the blood:

  • Kidney disease
  • Liver disease

These conditions could be worsened by use of Methylergonovine:

  • Obliterative vascular disease
  • Sepsis

Other medical problems could also affect the use of Methylergonovine. Ensure that your doctor is fully aware of all of your medical conditions before you begin using this treatment.

Warnings

Before you begin use of Methylergonovine it is important that you understand the risks of use and have weighed them against the benefits of use. You should decide to use this medication only having ensured that all of the following has been considered with your doctor:

Allergies ' You must inform your doctor of any unusual allergic reactions that you have suffered to medications in the past. You must also tell your doctor of any other allergies that you have suffered from. The presence of certain allergies may prohibit the use of this treatment.

Pediatric'This medication is not intended for the use in children and safety and efficiency have not been established. This medication should only be used to stop uteral bleeding following childbirth. Use in children below the age of 16 must be at the discretion of the prescribing doctor.

Geriatric 'Elderly patients have not been specifically tested for use of this medication due to the limited number of pregnancies in the geriatric population. Elderly patients are not expected to react differently to Methylergonovine. They are, however, more likely to have conditions of the liver or kidney that may limit use.

Pregnancy ' This medication should not be used while you are still pregnant. There is a significant risk of use during pregnancy.

Breastfeeding ' This medication can alter the composition of breast milk. If you are breastfeeding with this medication then the infant will need to be monitored for side effects. Be sure to discuss the risks and benefits with your doctor before beginning use.

Your doctor will need to make regular checks on your health and condition while you are taking this medication. Your doctor will check for continued signs of bleeding and will determine how long you should continue to take the medication. They will also look for any unwanted side effects.

Your chance of suffering from a heart attack will be increased when you are taking this medication. This risk will be increased in patients with high cholesterol or diabetes. It will also be more likely in patients with a history or heart conditions and in patients who smoke and are overweight. You should call your doctor straight away if you suffer chest pain, nausea, vomiting or discomfort of the arms, jaw, back or neck.

You should not take any other medication with Methylergonovine unless it has been approved by your doctor. This includes all kinds of medications including all non-prescription treatments.

Storage

This medication can be stored at room temperature. It should, however, be kept away from direct light, moisture and heat. Prevent it from freezing.

You must keep this medication out of the reach of children.

Dispose of any unwanted or outdated medication promptly and safely as directed by your doctor or healthcare professional.

Summary

Methylergonovine is used following childbirth when the mother is suffering bleeding from the uterus. This relatively common condition can put the mother at extreme risk from loss of blood and needs to be treated. Methylergonovine works on the smooth muscles of the uterus to bring the bleeding to a stop.

Methylergonovine is taken by tablet 3-4 times daily as directed by the doctor. In taking this medication the bleeding can be controlled but your doctor will need to make regular checks while you are on this treatment. Treatment should not normally last for more than a week and your doctor will assess your condition and stop the treatment as soon as it is safe to do so and the bleeding is not going to return.

Breastmilk can be affected by the use of Methylergonovine and the composition of it can be changed. Patients should be aware of this and should discuss the risks of breastfeeding with their doctor before beginning treatment with this medication. The benefits of use, however, will usually outweigh the risks and the mother could be advised not to breastfeed until after this treatment has stopped.

This medication can cause serious harm to an unborn baby and should not ever be taken before the birth has been completed. The treatment should be administered only after birth and only when it is required.