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Methylergonovine (Methergine)

Anesthesia Implications
Classification:
Ergot Alkaloid, Uterotonic
Therapeutic Effects:
Arteriolar vasoconstriction
Duration:

Half-life: 2 hours

Primary Considerations:

Only given IM. Used to treat uterine atony after delivery of the baby and placenta. The primary use is to slow postpartum bleeding/hemorrhage. Methergine is typically used if Oxytocin was unsuccessful at slowing blood loss. May cause hypertension - this is why it is contraindicated in hypertensive/preeclamptic patients. Side effects also include severe nausea and vomiting.

Contraindications:

Preeclampsia, Hypertension, seizures, CVA, retinal detachment, and cardiac arrest

IV push dose:

NOT given IV - this would potentially cause severe hypertension, vasoconstriction, and cerebral hemorrhage

IM dose:

0.2 mg; Due to its long duration of action, a repeat dose may be given after 1 hour.

Reference

Chestnut. Chestnut’s obstetric anesthesia principles and practice. 5th edition. 2014.