Last update June 13, 2025

Methylergometrine Maleate

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Derived from ergot, used in the prevention and treatment of postpartum haemorrhage. Intramuscular, intravenous or oral administration.

It is excreted in breast milk in clinically insignificant amounts (Nakamichi 2012, Vogel 2004, Iwamura 1981, Erkkola 1978) and is undetectable 6 hours after administration. (Nakamichi 2012)

Except for some product information leaflets (EPhL 2024, AEMPS 2020), there are no reliable publications reporting problems in infants whose mothers took it, nor are they described in the English technical data sheets (FDA 2012, PhF 2008), and it is not contraindicated during breastfeeding in the French technical data sheet. (BDP 2025, ANSM 2015 and 2013) or others. (PhF 2008) 

In infants of 29 mothers who took methylergonovine postpartum (0.125 mg twice daily for 5 days or three times daily for 3 days), there were no differences in health or neonatal development during the 17-month follow-up compared to a control group. (Gilad 2017)

There is controversy about its antiprolactin effect and its ability to decrease milk production found by some authors. (Peters 1979, Dörner 1979, Weiss 1975, Pérez 1975, Shane 1974)

A decrease in milk production (Arabin 1986) and a decrease in the duration of breastfeeding have been reported, although not in the percentage of initiation. (Brown 2014, Jordan 2009)

Others find no decrease in prolactin or milk production (Gilad 2017, Moretti 2000, Javier del Castillo 1985, Jolivet 1978, Del Pozo 1975, Scapin 1983), nor in the rate of exclusive breastfeeding (Gilad 2017), or weight gain at one month of age (González 1984, Jolivet 1978), considering that treatments limited to the first week postpartum and at low doses do not affect breastfeeding or the infant.

It has frequent side effects (nausea, vomiting, headache, hypertension) that do not occur with oxytocin, which is therefore preferable for reducing the risk of postpartum haemorrhage.

Serious poisoning has occurred in newborns due to direct oral or intramuscular administration when confused with other neonatal medication (Aeby 2003, Dargaville 1998). Careful separation of this medication from that used for neonates in delivery rooms or operating theatres is recommended. (FDA 2012, Dargaville 1998)

There is insufficient data to know whether immediate breastfeeding is effective in preventing postpartum haemorrhage (Chelmow 2011), although immediate skin-to-skin contact after caesarean section resulted in greater uterine contraction and better maternal plasma haemoglobin levels at discharge. (Pérez 2023)

Alternatives

  • Misoprostol (Safe product and/or breastfeeding is the best option.)
  • Oxytocin (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

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.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

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
pKa 7.93 -
Tmax 1.12 ± 0.82 (0.5 - 3) hours
3.29 ± 1.31 (2 - 4) hours
M/P ratio 0.3 -
Theoretical Dose 0.0002 mg/Kg/d
Relative Dose 0.3 - 2 %

References

  1. BDP-France. Mehergin, Notice patient Base des Données Publique Médicaments 2025 Full text (link to original source) Full text (in our servers)
  2. EPhL. Methergin. Résumé des caractéristiques du produit Fiche technique 2024 Full text (in our servers)
  3. Pérez-Jiménez JM, Luque-Oliveros M, Gonzalez-Perez D, Rivera-Sequeiros A, Rodriguez-Blanco C. Does immediate skin-to-skin contact at caesarean sections promote uterine contraction and recovery of the maternal blood haemoglobin levels? A randomized clinical trial. Nurs Open. 2023 Feb;10(2):649-657. Abstract Full text (link to original source)
  4. AEMPS. Metilergometrina. Ficha técnica. 2020 Full text (in our servers)
  5. ANSM. Methergin. Résumé des caractéristiques du produit. Fiche technique. 2015 Full text (in our servers)
  6. 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
  7. [No authors listed] Methylergometrine: adverse effects in breastfed infants. Prescrire Int. 2014 Abstract
  8. ANSM- Groupe de Travail Reproduction, Grossesse et Allaitement. METHERGIN (Méthylergométrine) et allaitement. Document GT252013013. 2013 Full text (link to original source) Full text (in our servers)
  9. Nakamichi T, Yawata A, Hojo H, Kagaya H, Kobayashi S, Chikuma T. Monitoring of methylergometrine in human breast milk by solid-phase extraction and high-performance liquid chromatography with fluorimetric detection. Pharmazie. 2012 Jun;67(6):482-4. Abstract
  10. FDA. Methylergonovine Maleate. Drug Summary. 2012 Full text (in our servers)
  11. Chelmow D. Postpartum haemorrhage: prevention. BMJ Clin Evid. 2011 Abstract Full text (link to original source)
  12. PhF. Methylergonovine. Drug Summary. 2008 Full text (in our servers)
  13. 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
  14. Aeby A, Johansson AB, De Schuiteneer B, Blum D. Methylergometrine poisoning in children: review of 34 cases. J Toxicol Clin Toxicol. 2003 Abstract
  15. 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)
  16. 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
  17. Arabin B, Rüttgers H, Kubli F. [Effects of routine administration of methylergometrin during puerperium on involution, maternal morbidity and lactation]. Geburtshilfe Frauenheilkd. 1986 Abstract
  18. 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
  19. 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
  20. Iwamura S, Kambegawa A. Determination of methylergometrine and dihydroergotoxine in biological fluids. J Pharmacobiodyn. 1981 Apr;4(4):275-81. Abstract
  21. 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
  22. Dörner G, Faber G, Tabatt K, Wurzbach A. [Lactation inhibition by the early postpartum administration of Methylergobrevin]. Zentralbl Gynakol. 1979 Abstract
  23. Peters F, Lummerich M, Breckwoldt M. Inhibition of prolactin and lactation by methylergometrine hydrogenmaleate. Acta Endocrinol (Copenh). 1979 Abstract
  24. 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
  25. 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
  26. Del Pozo E, Brun Del Re R, Hinselmann M. Lack of effect of methyl-ergonovine on postpartum lactation. Am J Obstet Gynecol. 1975 Abstract
  27. 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
  28. Weiss G, Klein S, Shenkman L, Kataoka K, Hollander CS. Effect of methylergonovine on puerperal prolactin secretion. Obstet Gynecol. 1975 Abstract
  29. 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
  30. Shane JM, Naftolin F. Effect of ergonovine maleate on puerperal prolactin. Am J Obstet Gynecol. 1974 Abstract

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