What to Know About Methergine (Methylergonovine)

A type of medication used to stop uterine bleeding after childbirth.

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Methergine is a type of medication used to stop uterine bleeding after childbirth. It belongs to a class of drugs called ergot alkaloids. The active ingredient in Methergine is methylergonovine—its generic name.

This medication is available as an oral tablet or an injection which is given intravenously. 

Uses

Methergine is used to help control uterine bleeding and other uterine problems just after childbirth. It works by improving the strength of the uterus and the timing of uterine contractions to help control bleeding and also assist in the delivery of the placenta.

Off-Label Uses 

Even though it’s not approved by the Food and Drug Administration (FDA) for treating cluster headaches, Methergine is sometimes prescribed off-label for this. It is typically not prescribed for more than six months when used to treat cluster headaches.

Before Taking 

Before prescribing Methergine, your doctor will weigh the risks this medication might pose to you against its potential benefits. To do this, your doctor will look into your condition, your medical history, any other medications you might be taking and if you are likely to experience any severe side effects like an allergic reaction.

If you suspect you might have an allergic reaction to methylergonovine, discuss this with your doctor before taking Methergine. Methergine also contains inactive ingredients like corn starch, povidone, tartaric acid, and stearic acid.

It’s uncommon for people to have allergic reactions to Methergine, but it’s possible. Signs of an allergic reaction include trouble breathing, a rash, swollen face, tongue, or throat.

It’s also possible for you to have an allergic reaction to an inactive ingredient in this drug. This is why it’s advisable to go through the list of inactive ingredients and disclose any allergies you might have with your doctor. You should also tell your doctor if you are allergic to any other ergot alkaloids like ergonovine.

Talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

Precautions and Contraindications 

It’s important to share with your doctor any other medication, vitamins, and supplements you might be taking. This is to ensure that none of them contraindicate with Methergine. Some medications that might contraindicate with Methergine include: 

  • Antifungal medication such as Onmel and Diflucan  
  • Hepatitis C medication like Victrelis and Incivek
  • HIV and AIDS mediation such as Reyataz, Stribild, and Norvir
  • Serzone (an antidepressant)
  • Other ergot alkaloids such as Methysergide, Ergometrine, and Dostinex 

If you have a medical history of the following conditions, this medication might not be the best option for you. 

  • Heart disease 
  • Kidney disease 
  • High blood pressure 
  • High cholesterol 
  • Raynaud’s disease 
  • Pregnancy complications such as eclampsia and preeclampsia 

Other Ergot Alkaloids

Methergine belongs to a class of drugs called ergot alkaloids. There are several other drugs in this class, but only a few perform similar functions to Methergine. 

  • Ergometrine: This is a type of medication that is used to treat postpartum hemorrhaging and post abortion hemorrhaging. 
  • Dostinex: Dostinex is generically known as cabergoline. It is used to help reduce abnormally high prolactin levels in your body. Some studies show that high levels of prolactin during pregnancy may lead to miscarriage

Other ergot alkaloids include Methysergide and Dihydroergotamine which are used to treat migraine and cluster headaches.

Dosage 

Methergine comes in two forms, as an oral tablet and as an injection. Both the oral tablet and injection come in 0.2-milligram strengths. The injection is typically given slowly for no less than 60 seconds.

The oral tablet is usually administered three to four times a day for no more than a week after child birth. It is never given during pregnancy or before childbirth. If you are unsure about how to take this medication, read the prescription label or call your doctor.

Take this medication exactly as has been prescribed for you by your doctor. You shouldn’t take less than prescribed as this can affect the effectiveness of the drug. Taking more than prescribed on the other hand could cause an overdose.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

How to Take and Store 

Methergine injection is typically administered intravenously slowly for no less than 60 seconds. During this process, your blood pressure is closely monitored to avoid cerebrovascular or hypertensive incidents.

If you are prescribed the oral tablets you should swallow them whole without breaking or chewing them. Take the pills as directed by your doctor. If you miss a dose, take it as soon as you remember.

If it’s almost time for your next dose then skip the missed dose. To avoid missing a dose you can set an alarm to remind you to take them at the same times every day. The medication is typically not prescribed for use for more than one week.

To protect the efficacy of this medication, store it at room temperature in a dry place, away from direct light. You can take this medication with or without food. In deciding the best dosage for you your doctor will examine your condition, medical history, and your response to the medication.

Side Effects 

You might experience some side effects while using Methergine. The most common side effects are typically mild and will dissipate with time.

Common

Some common but mild side effects you might experience include:  

  • Headache 
  • Stuffy nose 
  • Nausea 
  • Vomiting 
  • Diarrhea 
  • Rash
  • Abdominal pain

If these side effects persist or worsen as you use this medication, you should contact your doctor. 

Severe 

Experiencing severe side effects while on Methergine is rare. However, in occasional cases, people might experience serious side effects like: 

  • Numbness or tingling in your fingers or toes 
  • Leg cramps 
  • Chest pain  
  • High blood pressure 
  • Blood in your urine 
  • Hallucinations 
  • Seizures

If you begin to experience any of the above symptoms, speak to your doctor immediately. However, you shouldn’t discontinue use until you speak to your doctor.

In some cases stopping a medication abruptly while experiencing side effects might only worsen them.

The above side effects are not a conclusive list of the possible side effects you could experience while using Methergine, if you experience any other side effects not listed above, you should contact your doctor immediately. 

Warnings and Interactions  

If you are breastfeeding, doctors advise that you pause while being treated with Methergine. This is because it’s possible for the medication to pass into your breast milk and adversely affect your baby. It is typically advised to wait at least 12 hours after you’ve been given the last dose of Methergine before resuming breastfeeding.

This gives the medication enough time to have passed from your system and your breast milk. 

People who have or at risk of developing coronary artery conditions like obesity and diabetes are at a higher risk of developing myocardial ischemia while using Methergine. Myocardial ischemia is a condition that causes your heart muscles not to get enough blood. This medication should only be administered after childbirth and shouldn’t be given at any stage of a pregnancy. Methergine may also reduce the amount of breast milk you produce while using it. 

Overdosing on Methergine is rare but could occur. Signs of an overdose include vomiting, trouble breathing, numbness or tingling in your fingers and toes, and seizures. If you experience or witness someone experiencing any of these symptoms contact emergency medical services immediately. 

Most doctors advise that you avoid taking grapefruit and grape juice while on this medication. Grapefruit has been found to cause some unwanted side effects. Some people might experience dizziness while using this medication. You also shouldn’t drive or use any heavy machinery after taking this medication, until you’ve monitored how it affects you. 

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Article Sources
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