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Ergometrine and methylergometrine — distinct preparations

Pregnancy & gynaecology-specific. Every dose row is source-referenced; verify against institutional protocols.

Ergometrine and methylergometrine — distinct preparationsEMERGENCY KITErgot alkaloid uterotonic

Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.

Ergometrine and methylergometrine — distinct preparations: indication-specific regimens
IndicationDoseRouteFrequencyDuration / preparationMaximumMonitoring / cautions
Alternative uterotonic for atonic PPH; use this row only when the ampoule is ERGOMETRINE
200–500 micrograms IM; severe haemorrhage option 250–500 micrograms slow IV by a senior clinician
IM; slow IV only for severe haemorrhage
Initial dose followed by reassessment; select another indicated intervention for continuing bleeding
Acute post-birth treatment; no routine multi-day course in this emergency row · 500 micrograms/mL formulation: 500 micrograms = 1 mL. For IV use the cited label permits dilution to 5 mL with sodium chloride 0.9%; administer slowly with BP monitoring
500 micrograms per dose in this label; do not substitute the methylergometrine schedule or invent a cumulative ceiling
Monitor
  • Quantified blood loss, uterine tone, BP/pulse, perfusion and urine output; record every dose and time
  • Persistent shock or bleeding needs source control and blood products in parallel; do not wait for all drug doses
  • BP before and after injection; chest pain, severe headache, peripheral ischaemia
Contraindications / cautions
  • Hypertension/pre-eclampsia/eclampsia, severe cardiac/vascular disease, severe renal/hepatic impairment
  • Never use before delivery of the last baby
Atonic PPH after delivery; this is NOT the same formulation/dose as ergometrine
0.2 mg (200 micrograms)
IM
May repeat after 2–4 h if necessary, following reassessment
Acute treatment after birth; do not prescribe repeated doses while delaying haemorrhage control · 0.2 mg/mL: 1 mL IM. Check the ampoule for the actual drug name. Routine IV use is avoided because of sudden hypertension/stroke risk
  • The product label advises no breastfeeding during treatment and for at least 12 h after the last dose; express/discard milk during that interval.
0.2 mg per injection; further doses require documented reassessment. No invented 15-minute repeat course
Monitor
  • Quantified blood loss, uterine tone, BP/pulse, perfusion and urine output; record every dose and time
  • Persistent shock or bleeding needs source control and blood products in parallel; do not wait for all drug doses
  • BP before each dose; chest pain, vasospasm, headache and neurological symptoms
Contraindications / cautions
  • Hypertension/pre-eclampsia/eclampsia; vascular or significant cardiac disease; before delivery of the last baby
  • Avoid strong CYP3A4 inhibitors; do not combine ergot preparations
Pregnancy safety
Post-BIRTH only (never before delivery - fetal effects)
Lactation
Methylergometrine label: avoid breastfeeding during treatment and for 12 h after the final dose; check the specific ergometrine product.
Adverse effects
Hypertensive crisis in PET, nausea, coronary spasm rare
Manufacturer / emccheckedIN REVIEW