Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 10 units/mL
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
- Eric Hollander, MD; Montefiore Medical Center, Univ. Hosp for Albert Einstein College of Medicine; Bronx, New York 10467
- Pr Maithe Tauber; Hospital des enfants, TSA70034 31059; Toulouse, FRANCE
Not applicable
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (6)
- fexinidazole
fexinidazole and oxytocin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- isoflurane
isoflurane and oxytocin both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and oxytocin both increase QTc interval. Avoid or Use Alternate Drug.
- mefloquine
mefloquine increases toxicity of oxytocin by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- misoprostol
misoprostol increases effects of oxytocin by pharmacodynamic synergism. Avoid or Use Alternate Drug. Misoprostol may augment the effects oxytocic agents, especially when given less than 4 hours before initiating oxytocin. .
- sevoflurane
sevoflurane and oxytocin both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (29)
- benzphetamine
oxytocin increases effects of benzphetamine by pharmacodynamic synergism. Use Caution/Monitor.
- carboprost tromethamine
carboprost tromethamine increases effects of oxytocin by pharmacodynamic synergism. Use Caution/Monitor.
- dexfenfluramine
oxytocin increases effects of dexfenfluramine by pharmacodynamic synergism. Use Caution/Monitor.
- dexmethylphenidate
oxytocin increases effects of dexmethylphenidate by pharmacodynamic synergism. Use Caution/Monitor.
- dextroamphetamine
oxytocin increases effects of dextroamphetamine by pharmacodynamic synergism. Use Caution/Monitor.
- diethylpropion
oxytocin increases effects of diethylpropion by pharmacodynamic synergism. Use Caution/Monitor.
- dinoprostone
dinoprostone increases effects of oxytocin by pharmacodynamic synergism. Use Caution/Monitor.
- dobutamine
oxytocin increases effects of dobutamine by pharmacodynamic synergism. Use Caution/Monitor.
- dopamine
oxytocin increases effects of dopamine by pharmacodynamic synergism. Use Caution/Monitor.
- ephedrine
oxytocin increases effects of ephedrine by pharmacodynamic synergism. Use Caution/Monitor.
- epinephrine
oxytocin increases effects of epinephrine by pharmacodynamic synergism. Use Caution/Monitor.
- fenfluramine
oxytocin increases effects of fenfluramine by pharmacodynamic synergism. Use Caution/Monitor.
- fostemsavir
oxytocin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- isoproterenol
oxytocin increases effects of isoproterenol by pharmacodynamic synergism. Use Caution/Monitor.
- lisdexamfetamine
oxytocin increases effects of lisdexamfetamine by pharmacodynamic synergism. Use Caution/Monitor.
- methamphetamine
oxytocin increases effects of methamphetamine by pharmacodynamic synergism. Use Caution/Monitor.
- methylenedioxymethamphetamine
oxytocin increases effects of methylenedioxymethamphetamine by pharmacodynamic synergism. Use Caution/Monitor.
- methylphenidate
oxytocin increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor.
- midodrine
oxytocin increases effects of midodrine by pharmacodynamic synergism. Use Caution/Monitor.
- norepinephrine
oxytocin increases effects of norepinephrine by pharmacodynamic synergism. Use Caution/Monitor.
- phendimetrazine
oxytocin increases effects of phendimetrazine by pharmacodynamic synergism. Use Caution/Monitor.
- phentermine
oxytocin increases effects of phentermine by pharmacodynamic synergism. Use Caution/Monitor.
- phenylephrine
oxytocin increases effects of phenylephrine by pharmacodynamic synergism. Use Caution/Monitor.
- phenylephrine PO
oxytocin increases effects of phenylephrine PO by pharmacodynamic synergism. Use Caution/Monitor.
- propylhexedrine
oxytocin increases effects of propylhexedrine by pharmacodynamic synergism. Use Caution/Monitor.
- pseudoephedrine
oxytocin increases effects of pseudoephedrine by pharmacodynamic synergism. Use Caution/Monitor.
- serdexmethylphenidate/dexmethylphenidate
oxytocin increases effects of serdexmethylphenidate/dexmethylphenidate by pharmacodynamic synergism. Use Caution/Monitor.
- xylometazoline
oxytocin increases effects of xylometazoline by pharmacodynamic synergism. Use Caution/Monitor.
- yohimbine
oxytocin increases effects of yohimbine by pharmacodynamic synergism. Use Caution/Monitor.
Minor (0)
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
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
Pregnancy & Lactation
Pregnancy
Oxytocin injection is used in pregnancy for induction of labor in patients with a medical indication for initiation of labor; stimulation or reinforcement of labor, as in selected cases of uterine inertia; and adjunctive therapy in management of incomplete or inevitable abortion; there are no known indications for use of this drug in first and second trimester of pregnancy other than in relation to spontaneous or induced abortion; based on wide experience with this drug and its chemical structure and pharmacological properties, it would not be expected to present a risk of fetal abnormalities when used as indicated
Lactation
Not known whether this drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution when oxytocin is administered to nursing woman
Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for oxytocin Injection and any potential adverse effects on breastfed child from oxytocin Injection or from underlying maternal condition
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.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
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Pitocin injection - | 10 unit/mL vial |  | |
| Pitocin injection - | 10 unit/mL vial |  | |
| oxytocin injection - | 10 unit/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
oxytocin injection
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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