oxytocin (Rx)

Brand and Other Names:Pitocin
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 10 units/mL
more...

Postpartum Hemorrhage

10 unit IM after delivery of placenta

Add 10-40 units; not to exceed 40 units; to 1000 mL of nonhydrating IV solution and infuse at necessary rate to control uterine atony

Labor Induction

0.5-1 mUnit/min IV, titrate 1-2 mUnit/min q15-60min until contraction pattern reached that is similiar to normal labor (usually 6 mUnits/min); may decrease dose after desired frequency of contraction reached and labor has progressed to 5-6 cm dilation

Incomplete or Inevitable Abortion

10-20 mUnit/min; not to exceed 30 units/12 hr

Monitor

Intrauterine pressure, fetal heart rate

Prader-Willi Syndrome (Orphan)

Orphan designation for treatment of Prader-Willi syndrome

Sponsor

  • Pr Maithe Tauber; Hospital des enfants, TSA70034 31059; Toulouse, FRANCE

Not applicable

Next:

Interactions

Interaction Checker

and oxytocin

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

            Sinus bradycardia, tachycardia, premature ventricular complexes & other arrhythmias

            Permanent CNS or brain damage, and death secondary to asphyxia

            Neonatal seizure

            Neonatal jaundice

            Fetal death

            Low Apgar score (5 min)

            Uteroplacental hypoperfusion & variable deceleration of fetal heart rate

            Fetal hypoxia

            Perinatal hepatic necrosis

            Fetal hypercapnia

            Severe decreases in maternal systolic & diastolic blood pressure, increases in heart rate, systemic venous return & cardiac output, & arrhythmia

            Previous
            Next:

            Warnings

            Black Box Warnings

            Elective induction of labor is defined as the initiation of labor in a pregnant individual who has no medical indications for induction.

            Because the available data are inadequate to evaluate the benefits-to-risks onsiderations, oxytocin is not indicated for elective induction of labor.

            Contraindications

            Significant cephalopelvic disproportion

            Unfavorable fetal positions or presentations, eg, transverse lies,which are undeliverable without conversion prior to delivery

            Obstetric emergencies that favor surgery

            Fetal distress where delivery is not imminent

            Where adequate uterine activity fails to achieve satisfactory progress

            Hyperactive or hypertonic uterus

            Contraindicated vaginal delivery, eg, invasive cervical carcinoma, active herpes genitalis, total placenta previa, vasa previa, & cord presentation or prolapse of cord

            Hypersensitivity

            Fetal distress, polyhydramnios, partial placenta previa, prematurity, borderline cephalopelvic disproportion, previous major surgery of cervix or uterus (incl C-section), overdistension of uterus, grand multiparity, invasive cervical carcinoma, history of uterine sepsis or traumatic delivery

            Hyperstimulation of the uterus, with strong (hypertonic) &/or prolonged (tetanic) contractions, or a resting uterine tone of 15-20 mm H2O between contractions may occur, possibly resulting in uterine rupture, cervical & vaginal lacerations, postpartum hemorrhage, abruptio placentae, impaired uterine blood flow, amniotic fluid embolism, & fetal trauma including intracranial hemorrhage

            Not indicated for elective labor induction

            Cautions

            If uterine hyperactivity occurs, discontinue immediately

            Intravenous preparations should be be administered by trained personnel

            Risk of severe water intoxication on prolonged administration due to its antidiuretic effects

            Restricting fluid intake may be warranted

            Uterine hypertonicity, spasm, rupture of the uterus, and tetanic contractions may occur from high doses

            IM not recommended for labor induction/augmentation

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: X

            Lactation: May be distributed milk; commencement of nursing should be delayed for at least 1 day when discontinued; use caution

            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

            Uterine stimulant, vasopressive, & antidiuretic effects; activates G-protein-coupled receptors that trigger increases in intracellular calcium levels in uterine myofibrils, which results in uterine contractions; increases local prostaglandin production, which further stimulates uterine contraction

            Pharmacokinetics

            Duration: 2-3 hr (IM); 1 hr (IV)

            Vd: 0.3 L/kg

            Metabolism: Rapidly metabolized in the liver and plasma

            Excretion: Urine (small amounts)

            Half-Life: 1-6 min; decreased in late pregnancy and during lactation

            Previous
            Next:

            Administration

            IV Incompatibilities

            Additive: fibrinolysin

            IV Compatibilities

            Solution: compatible w/ most common solvents

            Additive: chloramphenicol sodium succinate, metaraminol, netilmicin, sodium bicarbonate, thiopental, verapamil

            Y-site: heparin, hydrocortisone sodium succinate, insulin, meperidine, morphine sulfate, KCl, vitamin B/C, warfarin

            IV Preparation

            Dilute to 10 mU/mL by adding 10 U (1 mL) to 1000 mL of D5W, LR, or NS

            IV/IM Administration

            Administer by IV infusion using infusion control device, or

            By IM injection (not recommended in most cases)

            Storage

            Store at room temperature (15-25°C)

            Do not freeze

            Do not use solution if discolored or contains precipitate

            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