Composition
Inj 5 IU/10 IU: Per ml: Synthetic oxytocin 5 IU/10 IU. Inj 2 IU: Per 2 ml: Synthetic oxytocin 2 IU.
Indications & Dosage
Induction of labour, Stimulation of labour in hypotonic uterine inertia: BY IV INF: Adult: Initially 0.001-0.004 unit/minute, not to be started for 6 hours after administration of vaginal prostaglandin, dose increased at intervals of 30 minutes until a max. of 3-4 contractions occur every 10 minutes (0.01 units/minute is often adequate) up to max; 0.02 units/minute, if regular contractions not established after a total 5 units, stop induction attempt (may be repeated next day starting again at 0.001-0.004 units/minute). Caesarean section: BY SLOW IV INJ: Adult: 5 units immediately after delivery. Prevention of postpartum haemorrhage after delivery of placenta: BY SLOW IV INJ: Adult: 5 units, if INF previously used for induction or enhancement of labour, increase rate during third stage and for next few hours BY IM INJ: Adult: 10 units, can be used instead of oxytocin with ergometrine. Treatment of postpartum haemorrhage: BY SLOW IV INJ: Adult: 5 units, repeated if necessary. Treatment of severe cases of postpartum haemorrhage (following IV injection): BYIV INF: Adult:40 units, given in 500ml INF fluid given at a rate sufficient to control uterine atony. Incomplete, inevitable, or missed miscarriage: BY SLOW IV INJ: Adult: 5 units, followed by (by IV INF) 0.02-0.04 unit/minute if required, at faster rate of INF if necessary.
Administration
Give by IV infusion at a rate of 10-20 milli units (20-40 drops)/min. IV infusion (drip method) is the only acceptable method of parenteral administration for the induction or stimulation of labour. Accurate con-trol of the rate of infusion flow is essential. An infusion pump or other device and frequent monitoring of strength, frequency, and duration of contractions, resting uterine tone, and fetal heart rate are necessary for the safe administration of oxytocin for the induction or stimulation of labour. Restitute by adding oxytocin 1 ml (10 units) to 1000 ml of 0.9% aqueous NaCI or RL, the solution contains 10 milliunits/ml (0.01 units/ml). Use a constant infusion pump to accurately control the rate of infusion. For incomplete or inevitable abortion: Add oxytocin 10 units with 500 ml of physiologic saline solution or 5% dextrose in physiologic saline solution. For postpartum uterine bleeding: Add 10-40 units (max, 40 units) to 1000 ml of a nonhydrating diluent.
Stability
Store at controlled room temperature 15C-30C (59F-86F).
Contraindications
Condition where spontaneous labouror vaginal delivery inadvisable, avoid IV injection during labour, avoid prolonged administration in oxytocin-resistant uterine inertia, avoid rapid IV injection (may transiently reduce blood pressure), fetal distress (discontinue immediately), hypertonicuterine contractions (discontinue immediately), severe cardiovascular disease, severe preeclamptic toxaemia
Precautions
Avoid rapid IV injection (may transiently reduce blood pressure).Avoid large infusion volumes and restrict fluid intake by mouth (risk of hyponatraemia and water in toxication), enhancement of labour; presence of borderline cephalopelvic disproportion (avoid if significant) , history of lower-uterine segment caesarean section, mild to moderate pregnancy-induced cardiac disease and hypertension, risk factors for disseminated intravascular coagulation, secondary uterine inertia, women over35 years age
Interactions
Prostaglandin; effects enhanced by concomitant prostaglandins (very careful monitoring of uterine activity).Caudal block anaesthesia (may enhance hypertensive effects of sympathomimetic vasopressors).
Side Effects
Arrhythmia, headache, nausea, vomiting. Rare: Anaphylactoid reactions; dyspnoea, hypotension, or shock, disseminated intravascular coagulation, hyponatraemia associated with high doses with large infusion volumes of electrolyte-free fluid, rash, uterine hyperstimulation with excessive doses; may cause fetal distress, asphyxia, and death, or may lead to hypertonicity, tetanic contractions, soft-tissue damage or uterine rupture, uterine spasm (may occur at low doses), water intoxication associated with high doses with large infusion volumes of electrolyte-free fluid. Placental abruption and amniotic fluid embolism reported on overdose.