Methylergonovine
/api/v1/drug/methylergonovineMechanism of action
Sourced from openFDAMechanism-of-action classes: Dopamine Antagonists; HIV Protease Inhibitors.
Indications
Sourced from openFDA- Following delivery of placenta, for routine management of uterine atony, hemorrhage and subinvolution of the uterus. For control of uterine hemorrhage in the second stage of labor following delivery of the anterior shoulder.
Contraindications
Sourced from openFDA- Hypertension; toxemia; pregnancy; and hypersensitivity.contraindicated
Dosage & administration
Sourced from openFDAOrally One tablet, 0.2 mg, 3 or 4 times daily in the puerperium for a maximum of 1 week.
Warnings & precautions
Sourced from openFDAGeneral This drug should not be administered I.V. routinely because of the possibility of inducing sudden hypertensive and cerebrovascular accidents. If I.V administration is considered essential as a lifesaving measure, methylergonovine maleate should be given slowly over a period of no less than 60 seconds with careful monitoring of blood pressure. Intra-arterial or periarterial injection should be strictly avoided. Caution should be exercised in presence of impaired hepatic or renal function. Breast-feeding Mothers should not breast-feed during treatment with methylergonovine maleate tablets, USP. Milk secreted during this period should be discarded. Methylergonovine maleate tablets, USP may produce adverse effects in the breast-feeding infant. Methylergonovine maleate tablets, USP may also reduce the yield of breast milk. Mothers should wait at least 12 hours after administration of the last dose of methylergonovine maleate tablets, USP before initiating or resuming breast feeding. Coronary artery disease Patients with coronary artery disease or risk factors for coronary artery disease (e.g., smoking, obesity, diabetes, high cholesterol) may be more susceptible to developing myocardial ischemia and infarction associated with methylergonovine-induced vasospasm. Medication errors Inadvertent administration of methylergonovine maleate tablets, USP to newborn infants has been reported. In these cases of inadvertent neonatal exposure, symptoms such as respiratory depression, convulsions, cyanosis and oliguria have been reported. Usual treatment is symptomatic.
Adverse reactions
Sourced from openFDAThe most common adverse reaction is hypertension associated in several cases with seizure and/or headache. Hypotension has also been reported. Abdominal pain (caused by uterine contractions), nausea and vomiting have occurred occasionally. Rarely observed reactions have included: acute myocardial infarction, transient chest pains, vasoconstriction, vasospasm, coronary arterial spasm, bradycardia, tachycardia, dyspnea, hematuria, thrombophlebitis, water intoxication, hallucinations, leg cramps, dizziness, tinnitus, nasal congestion, diarrhea, diaphoresis, palpitation, rash, and foul taste. There have been rare isolated reports of anaphylaxis, without a proven causal relationship to the drug product. Postmarketing Experience The following adverse drug reactions have been derived from post-marketing experience with methylergonovine maleate via spontaneous case reports. Because these reactions are reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency which is therefore categorized as not known. Nervous system disorders Cerebrovascular accident, paraesthesia Cardiac disorders Ventricular fibrillation, ventricular tachycardia, angina pectoris, atrioventricular block
Use in specific populations
Sourced from openFDAPregnancy Category C Animal reproductive studies have not been conducted with methylergonovine maleate. It is also not known whether methylergonovine maleate can cause fetal harm or can affect reproductive capacity. Use of methylergonovine maleate is contraindicated during pregnancy because of its uterotonic effects. (See INDICATIONS AND USAGE ).
Overdosage
Sourced from openFDASymptoms of acute overdose may include: nausea, vomiting, oliguria, abdominal pain, numbness, tingling of the extremities, rise in blood pressure, in severe cases followed by hypotension, respiratory depression, hypothermia, convulsions, and coma. Because reports of overdosage with methylergonovine maleate are infrequent, the lethal dose in humans has not been established. The oral LD 50 (in mg/kg) for the mouse is 187, the rat 93, and the rabbit 4.5. Several cases of accidental methylergonovine maleate injection in newborn infants have been reported, and in such cases 0.2 mg represents an overdose of great magnitude. However, recovery occurred in all but one case following a period of respiratory depression, hypothermia, hypertonicity with jerking movements, and convulsions. Also, several children 1-3 years of age have accidentally ingested up to 10 tablets (2 mg) with no apparent ill effects. A postpartum patient took 4 tablets at one time in error and reported paresthesias and clamminess as her only symptoms.
Approval history
Sourced from openFDA- Nov 24, 2008ANDAANDA090193Am Regent
- Sep 13, 2010ANDAANDA040889Breckenridge
- May 2, 2011ANDAANDA091577Chartwell Rx
- May 15, 2018ANDAANDA210424Granules
- Sep 10, 2018ANDAANDA211483Amneal Pharms
- Mar 20, 2019ANDAANDA211455Teva Pharms Usa
- May 1, 2020ANDAANDA212233Tp Anda Holdings
- Jan 15, 2021ANDAANDA211919Rising
FAERS reports
- 1Wrong Drug Administered6910%
- 2Drug Exposure During Pregnancy517.7%
- 3Vomiting466.9%
- 4Drug Ineffective446.6%
- 5Dyspnoea395.9%
- 6Headache385.7%
- 7Abdominal Pain365.4%
- 8Nausea365.4%
- 9Haemorrhage304.5%
- 10Dizziness274.1%
- 11Cyanosis263.9%
- 12Maternal Exposure During Pregnancy263.9%
- 13Pain263.9%
- 14Hypertension243.6%
- 15Accidental Exposure223.3%
Literature
Recent PubMed references pinned to Methylergonovine as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Methylergometrine-induced acute coronary vasospasm in a postpartum patient following caesarean delivery of DCDA twins.BMJ case reports · 2026 · Nair S, Bhat D, Hebbar S, et al.PMID 41734958DOI 10.1136/bcr-2025-269247
- Molecular regulatory effect of the ergot alkaloid methylergometrine on the α3β4 nicotinic acetylcholine receptor.Biochemical and biophysical research communications · 2025 · Kim C, Pyeon M, Yun J, et al.PMID 39721311DOI 10.1016/j.bbrc.2024.151233
- Second-Line Uterotonics for Uterine Atony: A Randomized Controlled Trial.Obstetrics and gynecology · 2024 · Cole NM, Kim JJ, Lumbreras-Marquez MI, et al.PMID 39326051DOI 10.1097/AOG.0000000000005744
- A comparison of misoprostol with and without methylergometrine and oxytocin in outpatient medical abortion: a phase III randomized controlled trial.BMC research notes · 2023 · Jahromi AR, Rahmanian V, Taghizadeh H, et al.PMID 37798748DOI 10.1186/s13104-023-06509-6
- Designing the 5HT(2B)R structure and its modulation as a therapeutic target for repurposing approach in drug-resistant epilepsy.Epilepsy research · 2023 · Chauhan A, Singh J, Sangwan N, et al.PMID 37302343DOI 10.1016/j.eplepsyres.2023.107168
- Post-partum myocardial ischemia due to intramuscular methylergonovine-induced coronary vasospasm: case report.BMC cardiovascular disorders · 2023 · Jang SK, Berlacher K, Hauspurg A, et al.PMID 37069508DOI 10.1186/s12872-023-03216-9
- Preventing postpartum hemorrhage with combined therapy rather than oxytocin alone.American journal of obstetrics & gynecology MFM · 2023 · Jones AJ, Federspiel JJ, Eke AC, et al.PMID 36028160DOI 10.1016/j.ajogmf.2022.100731
- Prophylactic Methylergonovine and Oxytocin Compared With Oxytocin Alone in Patients Undergoing Intrapartum Cesarean Birth: A Randomized Controlled Trial.Obstetrics and gynecology · 2022 · Masse N, Dexter F, Wong CA, et al.PMID 35852267DOI 10.1097/AOG.0000000000004857
Clinical trials
The 10 most recently updated of 15 ClinicalTrials.gov registrations naming Methylergonovine as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Ergometrine Versus Carbetocin to Decrease Blood Loss in MyomectomyRecruiting · Interventional · 40 enrolled · Cairo UniversityNCT07390864updated 2026-02-05
- Cooling the Uterus in C-section After Dysfunctional LaborTerminated · Interventional · 8 enrolled · Baylor Research InstituteNCT02910115updated 2026-01-26
- Prophylactic Regimen of Intravenous Oxytocin, Intravenous Tranexamic Acid, and Intramuscular Ergot Derivative for Primary Prevention of Postpartum Hemorrhage in Intrapartum Cesarean Section Versus Intravenous Carbetocin AloneNot yet recruiting · Interventional · 80 enrolled · Cairo UniversityNCT07318467updated 2026-01-06
- Second-Line Uterotonics in Postpartum Hemorrhage: A Randomized Clinical TrialCompleted · Phase 4 · Interventional · 100 enrolled · Brigham and Women's HospitalNCT03584854updated 2025-10-16
- Prophylactic Methylergonovine for Twin CesareanCompleted · Phase 4 · Interventional · 66 enrolled · Columbia UniversityNCT05772156updated 2025-06-13
- Oxytocin Bolus Versus Infusion in Elective Cesarean Section"Unknown · Phase 4 · Interventional · 120 enrolled · Stony Brook UniversityNCT05236985updated 2024-03-15
- Misoprostol Versus Active Management of Labour in CSCompleted · Phase 1 · Interventional · 300 enrolled · Aljazeera HospitalNCT03390010updated 2022-11-16
- Multimodal Uterotonics at the Time of Cesarean Section in Laboring PatientsCompleted · Phase 4 · Interventional · 160 enrolled · Cynthia WongNCT03904446updated 2022-08-01
- Carbetocin Versus Syntometrine for Prevention of Postpartum Hemorrhage After Cesarean SectionCompleted · Phase 4 · Interventional · 300 enrolled · Cairo UniversityNCT02044549updated 2021-06-24
- Intravenous Versus Intramuscular Administration of Methylergonovine for Uterine Contraction in Cesarean SectionsWithdrawn · Early phase 1 · Interventional · 0 enrolled · Johns Hopkins UniversityNCT03303235updated 2020-08-03
Frequently asked questions
- How does Methylergonovine work?
- Mechanism-of-action classes: Dopamine Antagonists; HIV Protease Inhibitors.
- What is Methylergonovine used for?
- According to FDA labeling, Methylergonovine carries indications including: Following delivery of placenta, for routine management of uterine atony, hemorrhage and subinvolution of the uterus. For control of uterine hemorrhage in the second stage of labor following delivery of the anterior shoulder.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Methylergonovine?
- Methylergonovine is classified as Ergot alkaloids, Ergot Derivative, Dopamine Antagonists, HIV Protease Inhibitors, Increased Uterine Smooth Muscle Contraction or Tone.
- What are the brand names for Methylergonovine?
- Methylergonovine is marketed under brand names including Methergine.
- What are the contraindications for Methylergonovine?
- Methylergonovine labeling lists contraindications including: Hypertension; toxemia; pregnancy; and hypersensitivity.. Always consult the full prescribing information and a clinician.
methylergonovine is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.