Oxytocin - Instructions For Use, Indications, Doses, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Oxytocin

Instructions for use:

1. 1. Release form and composition
2. 2. Indications for use
3. 3. Contraindications
4. 4. Method of application and dosage
5. 5. Side effects
6. 6. Special instructions
7. 7. Drug interactions
8. 8. Analogs
9. 9. Terms and conditions of storage
10. 10. Terms of dispensing from pharmacies

Prices in online pharmacies:

from 25 rubles.

Buy

Oxytocin is a synthetic hormonal drug to stimulate labor.

Release form and composition

Dosage form - solution for intramuscular (i / m) and intravenous (i / v) administration: clear colorless liquid without mechanical impurities (1 ml in glass ampoules, 5 ampoules in a cardboard box).

The active substance is oxytocin, in 1 ampoule - 5 international units (ME).

Auxiliary components: ethanol (96%), chlorobutanol hemihydrate, glacial acetic acid, water for injection.

Indications for use

• Stimulation of labor in the first and second stages of labor with weakness (primary or secondary) of labor pains;
• Labor induction in the late or close to it period of pregnancy, if premature birth is necessary due to intrauterine fetal growth retardation, Rh-conflict, gestosis, premature or early rupture of the membranes of the fetus and rupture of amniotic fluid, intrauterine fetal death, post-term pregnancy (after 42 weeks);
• Prevention and treatment of hypotonic bleeding after abortion, childbirth, cesarean section (after childbirth and separation of the placenta) (in order to accelerate postpartum uterine involution);
• Additional therapy for missed or incomplete abortion.

Contraindications

• A narrow pelvis of a woman in labor (discrepancy between the size of the pelvis and the head of the fetus), presentation or prolapse of the umbilical cord, partial or complete presentation of the placenta, oblique and transverse position of the fetus, which prevents spontaneous delivery;
• Emergency situations requiring surgical intervention caused by the condition of the fetus or woman in labor;
• Excessive stretching of the uterus;
• Facial presentation of the fetus;
• Compression of the fetus;
• Uterine sepsis;
• Fetal distress long before the onset of terminal pregnancy;
• Severe gestosis (impaired renal function, high blood pressure), hypertonicity of the uterus (appeared before childbirth);
• Heart disease, arterial hypertension;
• Impaired renal function;
• Breastfeeding period;
• Hypersensitivity to oxytocin and other components of the drug.

The drug is contraindicated for long-term use with passivity of the uterus.

In addition to special circumstances, the use of Oxytocin is also contraindicated in cases of multiple pregnancies, premature birth, uterine hypertonicity, a history of extensive surgical intervention on the uterus and cervix (including cesarean section), invasive stage of cervical carcinoma.

Method of administration and dosage

The solution is used by intravenous and intramuscular administration.

For artificial excitement and stimulation of the increase in labor, the drug is administered exclusively intravenously in a hospital using special equipment that provides appropriate medical control.

It is impossible to simultaneously enter the solution in / in and in / m.

The dose is prescribed by the selection method, taking into account the individual tolerance of the woman in labor and the fetus.

The introduction of oxytocin for labor arousal and stimulation of labor contractions is performed intravenously using an infusion pump and special equipment that allows you to monitor the fetal heart rate and the strength of uterine contractions.

With an excessive increase in the contractile activity of the uterus, the infusion must be stopped immediately to quickly reduce the contractile activity of the uterus.

Labor arousal begins with the introduction of pure saline. Then proceed to the standard infusion, dissolving 1 ml of oxytocin in 1000 ml of non-hydrating liquid and mixing thoroughly. The initial injection rate is from 2 to 16 drops per minute. To achieve the desired degree of uterine contractile activity, the rate is increased by 4-8 drops every 20-40 minutes. When the uterine contractions begin to correspond to the natural labor activity, and the opening of the pharynx of the uterus reaches 4-6 cm, in the absence of symptoms of fetal distress, it is recommended to gradually decrease the infusion rate in the reverse order corresponding to its acceleration.

The infusion rate in late pregnancy should not exceed 32-36 drops per minute, except in rare cases.

In case of premature birth, it is possible to use a high rate of drug administration, sometimes up to 80 drops per minute.

Infusion should be accompanied by regular close monitoring of fetal heart rate, uterine tone at rest, frequency, strength and duration of its contractions.

With uterine hyperactivity or fetal distress, the administration of oxytocin should be stopped immediately, oxygen therapy should be provided to the woman in labor and her condition and fetus should be monitored by a specialist doctor.

For the prevention and treatment of hypotonic bleeding in the postpartum period, an intravenous infusion of 2-8 ml of Oxytocin dissolved in 1000 ml of non-hydrating liquid is indicated; for the prevention of uterine atony, 80-160 drops per minute are usually needed.

After separation of the placenta, 1 ml of oxytocin is injected intramuscularly.

In case of incomplete or failed abortion, the patient is injected intravenously at a rate of 20-40 drops per minute, 2 ml of the drug diluted in 500 ml of saline or a mixture of 5% dextrose and saline.

Side effects

• Reproductive system: at high doses or hypersensitivity - uterine hypertonicity, tetany, spasm, uterine rupture, increased bleeding after childbirth (due to thrombocytopenia, hypoprothrombinemia or afibrinogenemia caused by oxytocin); sometimes - hemorrhages in the pelvic organs;
• Digestive system: nausea, vomiting;
• Cardiovascular system: at high doses - ventricular premature beats, arrhythmia, severe hypertension (against the background of the use of vasopressors), hypotension (when combined with the anesthetic cyclopropane), reflex tachycardia, shock; at a high rate of administration - subarachnoid bleeding, bradycardia;
• Water and electrolyte metabolism: with prolonged (24 hours) slow intravenous administration, severe hyperhydration (usually at a high infusion rate) may occur, occurring with convulsions and coma; rarely - death;
• Immune system: development of allergic reactions (including anaphylaxis); at a high rate of administration - bronchospasm; rarely - death.

In addition, the use of Oxytocin for labor induction can cause side effects in the fetus or newborn in the form of neonatal jaundice, a low score within 5 minutes on the Apgar scale; at a high rate of administration - retinal hemorrhage, a decrease in fetal blood fibrinogen; with an increase in the contractile activity of the uterus - residual changes in the central nervous system, arrhythmia (including tachycardia, sinus bradycardia, ventricular extrasystole), fetal death as a result of asphyxia.

special instructions

The use of Oxytocin should be started after a careful assessment of the expected therapeutic effect with the possible risk of tetany and uterine hypertonia.

Stimulation of labor should not begin before the appearance of the fetal head at the entrance to the pelvis.

Intravenous administration of oxytocin should be carried out in a hospital under the constant supervision of experienced specialists, whose qualifications allow you to determine the first symptoms of complications and provide immediate assistance. Careful, regular monitoring of delivery reduces the risk of bleeding after delivery.

To avoid complications, the entire period of drug administration should be accompanied by monitoring of the cardiac activity of the mother and fetus, the dynamics of uterine contractions, and the blood pressure of the woman in labor.

Adequate use of oxytocin should induce uterine contractions similar to spontaneous labor. Improper use of the drug is dangerous for both the woman in labor and the fetus.

The danger of excessive uterine contractions can arise when the uterus is hypersensitive to oxytocin.

The risk of developing afibrinogenemia and increased blood loss should be considered.

Oxytocin has an antidiuretic effect, therefore, with constant infusion and with additional oral fluid intake, the possibility of developing overhydration increases.

The drug can be mixed with sodium chlorate, sodium lactate and glucose solutions. The ready-made infusion solution must be used within the first 8 hours.

Oxytocin does not affect the ability to drive vehicles and mechanisms.

Drug interactions

The development of severe arterial hypertension is possible with the use of oxytocin 3-4 hours after the introduction of caudal anesthesia in conjunction with vasoconstrictors.

The combination of the drug with halothane, cyclopropane can cause a change in its cardiovascular action and cause the unforeseen development of arterial hypotension, sinus bradycardia and atrioventricular rhythm in a woman in labor during anesthesia.

Analogs

Oxytocin analogues are: Oxytocin-Vial, Oxytocin-Ferein, Oxytocin-Grindeks, Oxytocin-Richter, Oxytocin-MEZ, Pitocin, Synthocinon.

Terms and conditions of storage

Keep out of the reach of children.

Store in a dark place at a temperature of 2 to 15 ° C.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Oxytocin: prices in online pharmacies

Drug name Price Pharmacy

Oxytocin 5 IU / ml solution for injection and topical application 1 ml 10 pcs. RUB 25 Buy

Oxytocin 5 IU / ml solution for intravenous and intramuscular administration 1 ml 5 pcs. RUB 29 Buy

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!