Possible Interaction: Ergonovine and Oxytocin

“ Ergometrine plus oxytocin and misoprostol plus oxytocin cause significant side effects.”

“ Ergometrine plus oxytocin combination was more effective for preventing PPH ≥ 1000 mL than oxytocin.”

“… ergometrine … oxytocin combination had the higher risk for vomiting (RR 3.10 (95% CI 2.11 to 4.56), high-quality evidence; 1.9% versus 0.… fever (RR 3.18 (95% CI 2.22 to 4.55), moderate-quality evidence; 11.4% versus 3.6%) when compared with oxytocin.”

“There … ergometrine … oxytocin (RR 0.70, 95% CI 0.59 to 0.84, moderate certainty), carbetocin (RR 0.72, 95% CI 0.56 to 0.93, … misoprostol plus oxytocin (RR 0.70, 95% CI 0.58 to 0.86, low certainty) may reduce PPH ≥ 500 mL compared with oxytocin.”

“However, in the oxytocin-pretreated myometrium, a synergistic response is evident, and the combination of oxytocin with either ergonovine or carboprost produces superior response compared with oxytocin alone.”

“We hypothesized that the use of ergonovine or carboprost in combination with oxytocin would improve contractility compared with oxytocin alone.”

“… oxytocin (… ergonovine (2.13 [0.30], P < 0.001 [multiple comparisons adjusted P value, P < 0.001]), carboprost (1.88 [0.10], P < 0.001 [P < … (3.39 [0.32], P = 0.68 [P = 0.99]) and carboprost + HDOx (2.68 [0.30], P = 0.20 [P = 0.60]).”

“However, the use of prophylactic oxytocin was associated with fewer side effects, specifically … use to prevent PPH.There is no evidence of benefit when adding oxytocin … ergometrine compared to ergot alkaloids alone, and there may even be increased … associated with increased mean blood loss compared to ergot alkaloids alone.”

“ Ergonovine can be used for prevention of PPH but may be considered second choice to oxytocin owing to the greater risk of maternal adverse effects and of the need for manual removal of a retained placenta.”

“Use of a combined preparation of oxytocin and ergometrine resulted in the lowest blood losses.”

“Blood pressure was also raised in some patients following the use of intramuscular oxytocin and ergometrine (Syntometrine).”

“ Oxytocin pretreatment significantly suppressed the mean amplitude of the myometrial contractions as compared to the controls when the … to oxytocin (1.02 vs 1.74 g; P < .0001), but not with further exposure to ergonovine (0.77 vs. 0.58 g; P = .….83 vs 0.94 g; P = .4).”

“Misoprostol, ergometrine and the combination of oxytocin + ergometrine were assessed as probably inferior whilst the combination of oxytocin + misoprostol was assessed as definitely inferior to oxytocin.”