Methylergometrine is a smooth muscle constrictor that mostly acts on theuterus. It is most commonly used to prevent or control excessive bleeding following childbirth and spontaneous or elective abortion, and also to aid in expulsion of retained products of conception after a missed abortion (miscarriage in which all or part of the fetus remains in the uterus) and to help deliver the placenta after childbirth. It is available as tablets or injection (IM orIV) or in liquid form to be taken orally.[3][4][5]
Methylergometrine is sometimes used for both prevention[6] and acute treatment[7] of migraine. It is anactive metabolite ofmethysergide.[8] In the treatment ofcluster headaches, methylergometrine has been initiated at a dose of 0.2 mg/day, rapidly increased to 0.2 mg three times per day, and increased to a maximum of 0.4 mg three times per day.[8]
Methylergometrine is contraindicated in patients withhypertension andpre-eclampsia.[3] It is also contraindicated inHIV positive patients takingprotease inhibitors,delavirdine, andefavirenz (which is also an agonist at the 5-HT2A–mGlu2 receptor protomer and increases the chances of a patient experiencing hallucinations during methylergometrine therapy).[9]
Methylergometrine likely interacts with drugs that inhibit the liver enzymeCYP3A4, such asazole antifungals,macrolide antibiotics and many HIV drugs. It can also increase constriction of blood vessels caused bysympathomimetic drugs and other ergot alkaloids.[3]
^Ott J, Neely P (April 1980). "Entheogenic (hallucinogenic) effects of methylergonovine".Journal of Psychedelic Drugs.12 (2):165–166.doi:10.1080/02791072.1980.10471568.PMID7420432.
^abcdefJasek W, ed. (2007).Austria-Codex (in German) (62nd ed.). Vienna: Österreichischer Apothekerverlag. pp. 5193–5195.ISBN978-3-85200-181-4.
^Mutschler E, Schäfer-Korting M (2001).Arzneimittelwirkungen (in German) (8th ed.). Stuttgart: Wissenschaftliche Verlagsgesellschaft. p. 447.ISBN978-3-8047-1763-3.
^Pertz H, Eich E (1999). "Ergot Alkaloids and their Derivatives as Ligands for Serotonergic, Dopaminergic, and Adrenergic Receptors". In Křen V, Cvak L (eds.).Ergot: the genus Claviceps. CRC Press. pp. 411–440.
^Cavero I, Guillon JM (2014). "Safety Pharmacology assessment of drugs with biased 5-HT(2B) receptor agonism mediating cardiac valvulopathy".Journal of Pharmacological and Toxicological Methods.69 (2):150–161.doi:10.1016/j.vascn.2013.12.004.PMID24361689.
^Paulke A, Kremer C, Wunder C, Wurglics M, Schubert-Zsilavecz M, Toennes SW (April 2015). "Studies on the alkaloid composition of the Hawaiian Baby Woodrose Argyreia nervosa, a common legal high".Forensic Science International.249:281–293.doi:10.1016/j.forsciint.2015.02.011.PMID25747328.
^World Health Organization (2021).World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization.hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
^Hepp LC, Evans JR (December 1945). "Clinical comparison of methergine and natural ergonovine".Rocky Mountain Medical Journal.42: 949.PMID21007486.