Pronunciation:

meth-il-er-goe-NOE-veen

Brand Names:

• Methergine

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Uterine Stimulant

Chemical—

Ergot Alkaloid

Uses of This Medicine:

Methylergonovine injection is used to prevent and control bleeding from the uterus that can happen after childbirth. It belongs to the class of medicines called ergot alkaloids. This medicine works by acting directly on the smooth muscles of the uterus and prevents bleeding after giving birth.

This medicine is to be given only by or under the direct supervision of a doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of methylergonovine injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Although appropriate studies on the relationship of age to the effects of methylergonovine injection have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving methylergonovine injection.

Breast-feeding—

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Almotriptan
• Amprenavir
• Atazanavir
• Boceprevir
• Cobicistat
• Darunavir
• Delavirdine
• Dinoprostone
• Eletriptan
• Fosamprenavir
• Frovatriptan
• Indinavir
• Itraconazole
• Ketoconazole
• Lopinavir
• Naratriptan
• Nefazodone
• Nelfinavir
• Nirmatrelvir
• Ritonavir
• Rizatriptan
• Saquinavir
• Sumatriptan
• Telaprevir
• Telithromycin
• Tipranavir
• Voriconazole
• Zolmitriptan

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Clotrimazole
• Dopamine
• Droxidopa
• Ephedrine
• Epinephrine
• Fluconazole
• Fluoxetine
• Fluvoxamine
• Isoproterenol
• Lenacapavir
• Midodrine
• Norepinephrine
• Phenylephrine
• Propatyl Nitrate
• Zileuton

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Coronary artery disease or
• Diabetes or
• Hypercholesterolemia (high cholesterol in the blood)—May increase risk for more serious side effects.

• Hypertension (high blood pressure) or
• Toxemia (high blood pressure during pregnancy)—Should not be used in patients with these conditions.

• Kidney disease or
• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

• Obliterative vascular disease (blood vessel disease) or
• Sepsis (severe infection in the blood)—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given as a shot into a muscle or into a vein. This medicine is usually given after delivery of the placenta, or during the second stage of labor.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may change the amount of this medicine that is absorbed in the body.

Your doctor may also prescribe methylergonovine tablets for you to take. Be sure to follow all your doctor's instructions.

Precautions While Using This Medicine:

Your doctor will check your progress closely while you are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it.

Using this medicine while you are pregnant can harm your unborn baby. This medicine may cause contraction of the uterus and cause you to give birth early.

This medicine may increase your chance of having a heart attack. This is more likely to occur if you have diabetes, high cholesterol, or if you smoke or are overweight. Call your doctor right away if you have chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, trouble breathing, or sweating while using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Abdominal pain

headache

increased blood pressure

Rare

Blood in the urine

change in skin color

chest pain or discomfort

difficult or labored breathing

difficulty with swallowing

dizziness

fast, pounding, or irregular heartbeat or pulse

hives

lightheadedness, dizziness, or fainting

pain or discomfort in the arms, jaw, back, or neck

pain, tenderness, or swelling of the foot or leg

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

slow or fast heartbeat

skin rash

sweating

vomiting

Incidence not known

Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

confusion

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fainting

inability to speak

seizures

severe or sudden headache

slurred speech

temporary blindness

weakness in the arm or leg on one side of the body, sudden and severe

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

Continuous ringing or buzzing or other unexplained noise in the ears

cramps in the legs

diarrhea

foul taste

increased sweating

nausea

stuffy nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.