INDUCTION OF LABOUR FOR MEDICAL REASONS OR STIMULATION OF LABOUR IN HYPOTONIC UTERINE INERTIA, BY INTRAVENOUS INFUSION, SEE NICE GUIDANCE ABOVE; MAX. 5 UNITS IN 1 DAY (MAY BE REPEATED NEXT DAY STARTING AGAIN AT 0.001 - 0.002 UNITS/MINUTE)
IMPORTANT CAREFUL MONITORING OF FETAL HEART RATE AND UTERINE MOTILITY ESSENTIAL FOR DOSE TITRATION (AVOID INTRAVENOUS INJECTION DURING LABOUR); DISCONTINUE IMMEDIATELY IN UTERINE HYPERACTIVITY OR FETAL DISTRESS
CAESAREAN SECTION, BY SLOW INTRAVENOUS INJECTION IMMEDIATELY AFTER DELIVERY, 5 UNITS
PREVENTION OF POSTPARTUM HAEMORRHAGE, AFTER DELIVERY OF PLACENTA, BY SLOW INTRAVENOUS INJECTION, 5 UNITS (IF INFUSION USED FOR INDUCTION OR ENHANCEMENT OF LABOUR, INCREASE RATE DURING THIRD STAGE AND FOR NEXT FEW HOURS).
IMPORTANT AVOID RAPID INTRAVENOUS INJECTION (MAY TRANSIENTLY REDUCE BLOOD PRESSURE)
NOTE CAN BE GIVEN IN A DOSE OF 10 UNITS BY INTRAMUSCULAR INJECTION [UNLICENSED ROUTE] INSTEAD OF OXYTOCIN WITH ERGOMETRINE
TREATMENT OF POSTPARTUM HAEMORRHAGE, BY SLOW INTRAVENOUS INJECTION, 5 - 10 UNITS, FOLLOWED IN SEVERE CASES BY INTRAVENOUS INFUSION OF 5 - 30 UNITS IN 500 ML INFUSION FLUID AT A RATE SUFFICIENT TO CONTROL UTERINE ATONY
IMPORTANT AVOID RAPID INTRAVENOUS INJECTION (MAY TRANSIENTLY REDUCE BLOOD PRESSURE); PROLONGED ADMINISTRATION, SEE WARNING BELOW
INCOMPLETE, INEVITABLE, OR MISSED ABORTION, BY SLOW INTRAVENOUS INJECTION, 5 UNITS FOLLOWED IF NECESSARY BY INTRAVENOUS INFUSION, 0.02 - 0.04 UNITS/MINUTE OR FASTER
IMPORTANT PROLONGED INTRAVENOUS ADMINISTRATION AT HIGH DOSES WITH LARGE VOLUME OF FLUID (AS POSSIBLE IN INEVITABLE OR MISSED ABORTION OR POSTPARTUM HAEMORRHAGE) MAY CAUSE WATER INTOXICATION WITH HYPONATRAEMIA. TO AVOID: USE ELECTROLYTE-CONTAINING DILUENT (I.E. NOT GLUCOSE), INCREASE OXYTOCIN CONCENTRATION TO REDUCE FLUID, RESTRICT FLUID INTAKE BY MOUTH; MONITOR FLUID AND ELECTROLYTES.