About
Methergine

For the prevention and management of uterine hemorrhage1

Methergine® is the only
FDA-approved oral uterotonic1,2

  • Widely used in US hospitals, after oxytocin3 – Available for routine dosing from IM/IV to oral
  • Demonstrated tablet efficacy1,4 – Significant reduction in blood loss4 – Rapid onset of action (5-10 minutes)1
  • Generally well-tolerated safety profile1 – Lower risk of hemorrhage-related morbidity compared with carboprost5 – Comparable side-effect profile to misoprostol6,7 – No significant increase in ACS or AMI8
  • ACOG recommended as an appropriate first-line uterotonic agent unless contraindicated, as in patients with hypertension9,10
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References
  1. Methergine® (methylergonovine maleate) 0.2 mg Tablets Prescribing Information.
  2. U.S. Food and Drug Administration. Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. Available at: http://www.accessdata.fda.gov/scripts/cder/ob/docs/tempai.cfm. Accessed March 4, 2016.
  3. Bateman BT, Tsen LC, Liu J, et al. Patterns of second-line uterotonic use in a large sample of hospitalizations for childbirth in the United States: 2007-2011. Anesth Analg. 2014;119:1344-1349.
  4. Dweck ME, Lynch CM, Spellacy WN. Use of methergine for the prevention of postoperative endometritis in non-elective cesarean section patients. Infect Dis Obstet Gynecol. 2000;8(3-4):151-154.
  5. Butwick Aj, Carvalho B, Blumenfeld YJ, EI-Sayed,YY, Nelson LM, Bateman BT. Second-line uterotonics and the risk of hemorrhage-related morbidity. Am J Obstet Gynecol. 2015;212(5):642.e1-642.e7.
  6. Patil NB, Patted SS.A randomized controlled trial of oral misoprostol vs injection methylergometrine for prevention of post partum hemorrhage. Int J Reprod Contracept Obstet Gynecol. 2013;2:296-303.
  7. Amant F, Spitz B, Timmerman D, Corremans A, Van Assche FA. Misoprostol compared with methylergometrine for the prevention of postpartum haemorrhage: a double-blind randomized trial. Br J Obstet Gynecol. 1999;106:1066-1070.
  8. Bateman BT, Huybrechts KF, Hernandez-Diaz S, Liu J, Ecker JL,Avorn J. Methylergonovine maleate and the risk of myocardial ischemia and infarction. Am J Obstet Gynecol. 2013;209:459.e1-459.e13.
  9. Second-trimester abortion. Practice Bulletin No. 135. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013;121:1394-1406.
  10. Postpartum hemorrhage. Practice Bulletin No. 76. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2006;108:1039-1047.