oxytocin (Rx)

Brand and Other Names:Pitocin
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Dosing & Uses

AdultPediatric

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

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Interactions

Interaction Checker

and oxytocin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (4)

              • 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.

              • 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. .

              Monitor Closely (28)

              • 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.

              • 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)

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                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

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                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

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                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.

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                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

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                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

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Pitocin injection
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                10 unit/mL vial
                Pitocin injection
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                10 unit/mL vial
                Pitocin injection
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                10 unit/mL vial
                oxytocin injection
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                10 unit/mL vial
                oxytocin injection
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                10 unit/mL vial
                oxytocin injection
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                10 unit/mL vial
                oxytocin injection
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                10 unit/mL vial
                oxytocin injection
                -
                10 unit/mL vial
                oxytocin injection
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                10 unit/mL vial

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                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) 2021 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.

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                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.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.