Methergine (Injection)

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

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

Your doctor will monitor your progress closely while you are taking this medicine. This will help your doctor determine if the medicine is working correctly and if you should keep receiving it.

Using this medicine while you are pregnant can harm your unborn baby. This medicine may cause the uterus to contract and lead to early labor.

This medicine may increase your risk of having a heart attack. This risk is higher if you have diabetes, high cholesterol, or if you smoke or are overweight. Call your doctor immediately if you experience 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 you have talked about them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor must consider the risks of taking it compared to the benefits it can provide. For this medicine, keep the following in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medications. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For over-the-counter products, read the label or package ingredients carefully.

Pediatric

There have not been appropriate studies on how age affects the effects of methylergonovine injection in children. Safety and effectiveness have not been established.

Geriatric

While there have not been specific studies on how age affects the effects of methylergonovine injection in older adults, no specific problems for this age group have been reported so far. However, older patients are more likely to have age-related kidney, liver, or heart issues, which may need caution and adjustments in the dose for those receiving methylergonovine injection.

Breast Feeding

Studies indicate that this medicine may change milk production or its composition. If another medication is not prescribed, you should watch the infant for side effects and ensure they are getting enough milk.

Interactions with Medicines

Some medicines should not be taken together at all, while others may be used together even if there is a chance of an interaction. In those cases, your doctor may need to adjust the dose or take other precautions. It is very important for your healthcare professional to know if you are taking any of the medicines listed below when you are receiving this medicine. The following interactions are based on their potential significance and are not necessarily a complete list.

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
• Letermovir
• Lopinavir
• Naratriptan
• Nefazodone
• Nelfinavir
• Nirmatrelvir
• Posaconazole
• 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 necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both medicines.

• Dobutamine
• Dopamine
• Ephedrine
• Epinephrine
• Fluconazole
• Fluvoxamine
• Lenacapavir
• Norepinephrine
• Phenylephrine
• Propatyl Nitrate
• Vasopressin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be taken with food or certain types of food because interactions may happen. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions are based on their potential significance and are not necessarily a complete list.

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 specific instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other Medical Problems

Having other medical issues may affect how this medicine works. Be sure to 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 the risk of 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 stronger because the medicine is removed from the body more slowly.

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

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may occur, but if they do, they may require medical attention.

Check with your doctor or nurse right away if any of the following side effects happen:

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 happen that usually do not require medical attention. These side effects may go away during treatment as your body gets used to the medicine. Your health care professional may also be able to tell you ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, 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.

In the U.S.

• Methergine

Available Dosage Forms:

• Solution

Therapeutic Class: Uterine Stimulant

Chemical Class: Ergot Alkaloid

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.