Methylergonovine (Injection)

Methylergonovine (Injection) is used to prevent and control bleeding from the uterus that can occur after childbirth. It belongs to a group of medicines known as ergot alkaloids. This medicine works by acting directly on the smooth muscles of the uterus to prevent bleeding after giving birth.

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

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

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

This medicine may increase your risk of having a heart attack. This is more likely if you have diabetes, high cholesterol, 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 any other medicines unless you have discussed them with your doctor. This includes both prescription and nonprescription (over-the-counter [OTC]) medicines, as well as herbal or vitamin supplements.

In deciding to use this medicine, the risks must be weighed against the benefits. This is a decision for you and your doctor. Consider the following:

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 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 done on how methylergonovine (Injection) affects children. Its safety and effectiveness have not been established.

Geriatric

While appropriate studies on how methylergonovine (Injection) affects older adults have not been performed, no specific problems for older patients have been documented so far. However, elderly patients are more likely to have age-related kidney, liver, or heart issues, which may need caution and a dose adjustment for those receiving methylergonovine (Injection).

Breast Feeding

Studies suggest that this medication may change milk production or composition. If an alternative is not prescribed, you should monitor the infant for side effects and ensure they are getting enough milk.

Interactions with Medicines

Some medicines should never be used together. In other cases, two different medicines may be used together, even if an interaction might happen. In these situations, your doctor may change the dose or take other precautions. When receiving this medicine, it is very important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions are based on 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 your other medicines.

• 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 cases. If both medicines are prescribed together, your doctor may adjust the dose or frequency of use for one or both medicines.

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

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used around the time of eating food or certain types of food 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 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 provide special instructions regarding food, alcohol, or tobacco use.

• Grapefruit Juice

Other Medical Problems

Other medical issues may affect the use of this medicine. 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. Effects may be stronger due to 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 worsen these conditions.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may need 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 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 how 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:

• 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.