Methergine (Oral)

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

This medicine is available only with your doctor's prescription.

It is very important that your doctor check your progress at regular visits while you are taking this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take 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.

In deciding to use a medicine, you must consider the risks versus the benefits. This is a choice you will make with your doctor. 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 medicines. Also, let your healthcare professional know 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.

Pediatric

Appropriate studies have not been conducted on how methylergonovine affects children. Safety and effectiveness have not been established for this age group.

Geriatric

Although proper studies on how age affects methylergonovine have not been done 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 require careful monitoring and possible dose adjustments for those taking methylergonovine.

Breast Feeding

Studies indicate that this medication may change milk production or its composition. If no alternative medication is prescribed, you should watch the infant for side effects and ensure they are getting enough milk.

Interactions with Medicines

Some medicines should never be used together, while others can be combined even if an interaction might happen. In such cases, your doctor may adjust the dose or take other precautions. While taking this medicine, it is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are highlighted due to their potential significance and are not a complete list.

Using this medicine with any of the following medicines is not recommended. Your doctor may choose not to prescribe this medication or may change some of the other medicines you are taking.

• Almotriptan
• Amprenavir
• Atazanavir
• Boceprevir
• Cobicistat
• Darunavir
• Delavirdine
• 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 generally not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or frequency for 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 around mealtime or with certain foods due to possible interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions are based on their potential significance and are not a complete list.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some situations. If used together, your doctor may adjust the dose or frequency of this medicine, or provide special instructions regarding food, alcohol, or tobacco use.

• Grapefruit Juice

Other Medical Problems

Other medical issues may affect how this medicine works. Be sure to tell your doctor if you have any other medical conditions, 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 body removes the medicine 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 needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do happen, they may need medical attention.

Check with your doctor 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.

In the U.S.

• Methergine

Available Dosage Forms:

• Tablet

Therapeutic Class: Uterine Stimulant

Chemical Class: Ergot Alkaloid

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

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.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):For prevention of bleeding after childbirth: Adults—0.2 milligram (mg) three or four times a day, for up to 1 week. Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.