Last update Sept. 19, 2016

Methylergometrine Maleate

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Ergot derivative which is used in the prevention and treatment of postpartum hemorrhage.

It is not excreted into breast milk in clinically significant amount (Erkkola 1978) and, besides the information offered by the manufacturer, no reliable publications were found about problems in infants whose mothers were treated.

There is a controversy on an antiprolactin effect and its ability to decrease milk production found by some authors (Peters 1979, Döner 1979, Weiss 1975).
Some have published an association with a decreased in duration of breastfeeding though not in the percentage of initiation (Brown 2014, Jordan 2009) nor a decrease in weight gaining (Arabin 1986).
Others did not find a decrease in prolactin level (Javier del Castillo 1985, Del Pozo 1975), nor difference in the rate of exclusive breastfeeding or monthly weight gain (González1984), considering that the treatments limited to the first week postpartum that use a low dose do not affect lactation or the infant.

It has frequent side effects (nausea, vomiting, headache, hypertension) that do not occur with oxytocin, so the latter is preferable to reduce the risk of postpartum hemorrhage. There are insufficient data to know whether immediate breastfeeding is effective for this type of prevention (Chelmow 2011).
They have occurred serious poisonings in infants when giving directly both orally or intramuscularly due to confusion with other medication for newborns (Aeby 2003).

Alternatives

  • Misoprostol ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Oxytocin (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Methylergometrine Maleate is also known as


Methylergometrine Maleate in other languages or writings:

Group

Methylergometrine Maleate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Methylergometrine Maleate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 %
Molecular weight 456 daltons
Protein Binding 36 %
VD 0.78 l/Kg
Tmax 0.5 - 3 hours
T½ 2 - 3 hours
M/P ratio 0.3 -
Theoretical Dose 0.0002 mg/Kg/d
Relative Dose 0.3 - 2 %

References

  1. AEMPS. Metilergometrina. Ficha técnica. 2015 Full text (in our servers)
  2. Brown A, Jordan S. Active management of the third stage of labor may reduce breastfeeding duration due to pain and physical complications. Breastfeed Med. 2014 Dec;9(10):494-502. Abstract
  3. [No authors listed] Methylergometrine: adverse effects in breastfed infants. Prescrire Int. 2014 Abstract
  4. Groupe de Travail Reproduction, Grossesse et Allaitement (ANSM). METHERGIN (Méthylergométrine) et allaitement. Document GT252013013. 2013 Abstract Full text (link to original source) Full text (in our servers)
  5. FDA. Methylergonovine Maleate. Drug Summary. 2012 Full text (in our servers)
  6. Chelmow D. Postpartum haemorrhage: prevention. BMJ Clin Evid. 2011 Abstract
  7. Vogel D, Burkhardt T, Rentsch K, Schweer H, Watzer B, Zimmermann R, Von Mandach U. Misoprostol versus methylergometrine: pharmacokinetics in human milk. Am J Obstet Gynecol. 2004 Abstract
  8. Aeby A, Johansson AB, De Schuiteneer B, Blum D. Methylergometrine poisoning in children: review of 34 cases. J Toxicol Clin Toxicol. 2003 Abstract
  9. Moretti ME, Lee A, Ito S. Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician. 2000 Sep;46:1753-7. Review. Abstract Full text (link to original source) Full text (in our servers)
  10. de Groot AN, van Dongen PW, Vree TB, Hekster YA, van Roosmalen J. Ergot alkaloids. Current status and review of clinical pharmacology and therapeutic use compared with other oxytocics in obstetrics and gynaecology. Drugs. 1998 Abstract
  11. Malanetto C, Pomiato S, Armellino F, Contino B, Ragusa S, Falabella A, Spina A, Splendido M, Vidano E, Nubola S, et al. [Methylergometrine in early puerperium. Comparative research on its effects at the uterine level and on lactation]. Minerva Ginecol. 1986 Abstract
  12. Arabin B, Rüttgers H, Kubli F. [Effects of routine administration of methylergometrin during puerperium on involution, maternal morbidity and lactation]. Geburtshilfe Frauenheilkd. 1986 Abstract
  13. González P, Gayán P, Pineda G, Herrera R, Leyton M. [Plasma prolactin in the puerperium and its relation to the use of methylergonovine maleate]. Rev Chil Obstet Ginecol. 1984 Abstract
  14. Scapin F, Calistri D, Tronconi G, Pellicciotta G, Bareggi SR, Pontiroli AE. Inhibition of puerperal lactation by metergoline: interactions with methylergobasine maleate. Gynecol Obstet Invest. 1983 Abstract
  15. Javier del Castillo F, Ramírez BM, Díaz-Infante Ibarra A. [Effect of methylergovine on the secretion of prolactin in childbirth and the puerperium]. Ginecol Obstet Mex. 1980 Abstract
  16. Dörner G, Faber G, Tabatt K, Wurzbach A. [Lactation inhibition by the early postpartum administration of Methylergobrevin]. Zentralbl Gynakol. 1979 Abstract
  17. Peters F, Lummerich M, Breckwoldt M. Inhibition of prolactin and lactation by methylergometrine hydrogenmaleate. Acta Endocrinol (Copenh). 1979 Abstract
  18. Erkkola R, Kanto J, Allonen H, Kleimola T, Mäntylä R. Excretion of methylergometrine (methylergonovine) into the human breast milk. Int J Clin Pharmacol Biopharm. 1978 Abstract
  19. Jolivet A, Robyn C, Huraux-Rendu C, Gautray JP. [Effect of ergot alkaloid derivatives on milk secretion in the immediate postpartum period]. J Gynecol Obstet Biol Reprod (Paris). 1978 Jan;7(1):129-34. French. Abstract
  20. Del Pozo E, Brun del Re R, Hinselmann M, Wyss H. [Effect of methergine, oxytocin, pyridoxine (vitamin B 6) and quinestrol on prolactin and milk secretion in puerperium]. Arch Gynakol. 1975 Abstract
  21. Del Pozo E, Brun Del Re R, Hinselmann M. Lack of effect of methyl-ergonovine on postpartum lactation. Am J Obstet Gynecol. 1975 Abstract
  22. Perez-Lopez FR, Delvoye P, Denayer P, L'Hermite M, Roncero MC, Robyn C. Effect of methylergobasine maleate on serum gonadotrophin and prolactin in humans. Acta Endocrinol (Copenh). 1975 Abstract
  23. Weiss G, Klein S, Shenkman L, Kataoka K, Hollander CS. Effect of methylergonovine on puerperal prolactin secretion. Obstet Gynecol. 1975 Abstract

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