methylergonovine (Rx)

Brand and Other Names:Methergine
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 0.2mg/mL

tablet

  • 0.2mg
more...

Postpartum Hemorrhage

0.2 mg IM/IV q2-4hr PRN; not to exceed 5 doses, THEN 0.2-0.4 mg PO q6-8hr PRN for 2-7 days

Administer IV only in emergency because of potential for Hypertension & CVA

Administer over >1 minute and monitor BP

Refractory Cluster Headache (Off-label)

0.2 mg PO q6-8hr, not to exceed 6 months

Not applicable

Next:

Interactions

Interaction Checker

and methylergonovine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            Nausea/vomiting

            Dizziness

            Headache

            Tinnitus

            Diaphoresis

            Palpitation

            Transient chest pain

            Dyspnea

            Thrombophlebitis

            Hematuria

            Water intoxication

            Hallucinations

            Leg cramps

            Nasal congestion

            Diarrhea

            Foul taste

            Allergic phenomena including shock

            Hypertension

            Postmarketing reports

            Nervous system: Cerebrovascular accident, paraesthesia

            Cardiovascular: Ventricular fibrillation, ventricular tachycardia, angina pectoris, atrioventricular block

            Previous
            Next:

            Warnings

            Contraindications

            (All not necessarily unanimous): Hypertension, heart disease, toxemia, pregnancy, hypersensitivity, mitral valve stenosis, prolonged use

            Cases of threatened spontaneous abortion

            Avoid during breastfeeding

            Cautions

            Second or third stage of labor prior to placenta delivery: complications such as captivation of placenta may occur; avoid accidental injection to newborn babies

            Increased risk of myocardial ischemia and infarction with coronary artery disease or risk factors for coronary artery disease

            Sepsis, hepatic impairment, renal impairment, peripheral vascular disease

            Prolonged use may cause pleuropulmonary, cardiac or retroperitoneal fibrosis

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Excreted in milk; adverse effect on nursing infant; may inhibit lactation; not recommended

            Wait at least 12 hours after last dose to breastfeed

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Produces vasoconstriction to increase strength, duration, & frequency of uterine contraction which in turn impedes uterine blood flow

            Pharmacokinetics

            Bioavailability: 60% (PO); 78% (IM)

            Peak Plasma Time: 30 min

            Peak Plasma Concentration: 3 ng/mL

            Onset: uterine contractions are usually initiated within 5-15 min following oral administration, within 2-5 min after IM injection, & immediately following IV injection

            Duration: 3 hr (PO); 3hr (IM); 45 min (IV)

            Vd: 39-73L

            Metabolism: Liver

            Excretion: Urine and feces

            Half-Life

            • Initial phase: 1-5 min
            • Terminal phase: 0.5-2 hr
            Previous
            Next:

            Administration

            IV Administration

            Give IV only in emergency because of potential for HTN & CVA

            Give over >1 min & monitor BP & uterine contractions

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous