ergometrine maleate at a glance
Medicine class
Ergot alkaloid uterotonic
Main role
Helps manage the third stage of labour and postpartum haemorrhage
Administration
Given by a healthcare professional, usually by intramuscular injection; slow intravenous administration may be used for severe bleeding due to uterine atony
Important check
Blood pressure and cardiovascular history should be assessed because it can cause hypertension and vasoconstriction
What is ergometrine maleate used for?
The selected UK product is licensed for obstetric use under medical supervision.
Active management of the third stage of labour.
Treatment of postpartum haemorrhage.
How does ergometrine maleate work?
It activates serotonin 5-HT2 and alpha-adrenergic receptors in uterine muscle, producing sustained contraction of the womb. This compresses uterine blood vessels and helps reduce bleeding after birth.
ergometrine maleate preparations and strengths
Injection
Route: Parenteral
Strengths: 0.05% w/v
How to take ergometrine maleate
A doctor, midwife or nurse administers this injection; it is not for self-administration. Intramuscular injection is usual. Intravenous injection must be slow and is reserved for appropriate emergencies. It should not generally be mixed with other medicines in the same syringe.
Tell the maternity team about high blood pressure, pre-eclampsia, heart or circulation disease, Raynaud’s phenomenon, liver or kidney problems, infection and all medicines recently taken.
In breech or another abnormal presentation, it is withheld until the child is fully delivered; in multiple births, it is withheld until the last baby is delivered.
ergometrine maleate side effects
Common or expected effects
- Reported effects include nausea, vomiting, abdominal pain, headache, dizziness, ringing in the ears and skin rash; their frequencies are not stated in the product information.
- Raised blood pressure, palpitations, a slow or irregular heartbeat and chest discomfort can occur.
Get urgent medical advice
- Severe allergic reaction with breathing difficulty, swelling, low blood pressure, collapse or shock.
- Coronary artery spasm, severe chest pain or heart attack.
- Marked hypertension or reduced blood flow caused by vasoconstriction.
- Breathlessness or pulmonary oedema.
ergometrine maleate in pregnancy
It is contraindicated during pregnancy, induction and the first and second stages of labour before delivery of the baby’s anterior shoulder because it causes powerful uterine contraction. Timing requires expert obstetric supervision, especially with abnormal presentations or multiple births.
ergometrine maleate while breastfeeding
Ergometrine derivatives enter breast milk in unknown amounts. Ergometrine can suppress prolactin and reduce milk production, so repeated use should be avoided. Discuss concerns about repeated exposure or milk supply with the maternity or infant-feeding team.
ergometrine maleate interactions
The clinical team should check prescription, non-prescription and perioperative medicines before administration.
Strong CYP3A4 inhibitors, including clarithromycin, erythromycin, azole antifungals and some HIV medicines
May increase ergot exposure and the risk of severe vasospasm or tissue ischaemia; combined use should be avoided.
Grapefruit juice and weaker CYP3A4 inhibitors such as cimetidine
May increase exposure and the risk of ergot-related adverse effects.
Vasoconstrictors and sympathomimetics, including those in some local anaesthetics or cold remedies
Can intensify raised blood pressure and vasoconstriction.
Common questions about ergometrine maleate
Answers are fully visible for fast scanning and source review.
What is ergometrine maleate used for after childbirth?
It makes the womb contract strongly, helping manage delivery of the placenta and control postpartum bleeding.
Why is blood pressure checked before it is given?
It can narrow blood vessels and raise blood pressure. Severe hypertension, pre-eclampsia and eclampsia are contraindications.
Can it be given before the baby is born?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.