Release form: Liquid dosage forms. Injection.

General characteristics. Compound:

Active ingredient: 1 ml of solution contains 5 IU of oxytocin;

excipients: chlorobutanol hemihydrate, water for injection.

Main physiochemical properties: clear, colorless liquid with a specific odor.

Pharmacological properties:

Synthetic oxytocin has all the biological properties of the natural hormone secreted by the posterior pituitary gland.

Pharmacodynamics. Being a peptide hormone (octapeptide) of the posterior pituitary gland, it consists of an octapeptide cycle and a side chain of three amino acid residues (proline, leucine, glycine). Oxytocin is a drug that stimulates the muscles of the uterus. It causes especially strong contractions of the muscles of the uterus in pregnant women, which is due to its effect on the membranes of myometrial cells. The use of oxytocin increases the permeability of the membrane for potassium ions, reduces its potential and increases excitability. Oxytocin stimulates milk secretion by increasing the production of prolactin, the lactogenic hormone of the anterior pituitary gland. In addition, it activates the secretion of milk from the mammary gland due to the impact on its contractile elements. Oxytocin has a weak antidiuretic effect and does not significantly affect the level blood pressure.

Pharmacokinetics. Oxytocin in gastrointestinal tract is destroyed under the influence of enzymes (pepsin, trypsin), and therefore it is used parenterally. Does not bind to plasma proteins, metabolized by the liver, excreted by the kidneys. The half-life is 5 minutes.

Indications for use:

Induction of labor, stimulation of labor in primary and secondary labor weakness, as well as with caution in the first and second stages of labor. Prevention and treatment of placental and atonic uterine bleeding(in the case of a caesarean section, Oxytocin is injected directly into the uterine muscle). Insufficient involution of the uterus in the postpartum period (to control subinvolution and bleeding). Incomplete or . With gynecological bleeding (after establishing a histological diagnosis).

Important! Get to know the treatment

Dosage and administration:

The drug is administered intravenously, intramuscularly, subcutaneously, as well as into the cervix or uterine wall.

For the induction or stimulation of labor, oxytocin is used exclusively as an intravenous drip infusion. Compliance with the indicated infusion rate is mandatory. The safe use of oxytocin requires the use of an infusion pump or other similar device, as well as monitoring of uterine contractions and fetal cardiac activity. In the event of an excessive increase in the contractile activity of the uterus, the infusion should be stopped immediately, as a result of which the excessive uterine activity of the uterus will quickly decrease.

To prepare a standard infusion of oxytocin in 500 ml of a solvent (0.9% sodium chloride solution or 5% glucose solution), 1 ml (5 IU) of oxytocin should be dissolved and mixed. The rate of administration of the initial dose should not exceed 5-8 drops per minute. Every 20-40 minutes it can be increased by 5 drops, but not more than until reaching 40 drops per minute, until the desired degree of contractile activity of the uterus is reached. When the degree of uterine contractions corresponding to normal labor activity is reached, the opening of the cervix by 4-6 cm, in the absence of signs of fetal distress, the infusion rate can be gradually reduced at a pace similar to its acceleration. In the terminal period of pregnancy, oxytocin can be administered faster, but care must be taken, since only occasionally an infusion rate of up to 40 drops per minute may be needed. It is necessary to control the fetal heartbeat, the tone of the uterus at rest, the frequency, duration and strength of its contractions. In the event of excessive uterine contractions or fetal distress, oxytocin administration should be stopped immediately and oxygen therapy given to the parturient woman, while both the parturient woman and the fetus should be under the supervision of a specialist doctor.

To stop uterine bleeding in the postpartum period:

1) Intravenous drip infusion: dissolve 10-40 IU of oxytocin in 1000 ml (0.9% sodium chloride solution, 5% glucose solution).

2) Intramuscularly: 1 ml (5 IU) of oxytocin after separation of the placenta.

For the prevention of atonic uterine bleeding:

Oxytocin is administered intramuscularly at 3-5 IU 2-3 times a day daily for 2-3 days.

As adjuvant therapy for incomplete abortion:

10 IU of oxytocin in 500 ml of 0.9% sodium chloride solution or a mixture of 5% dextrose with 0.9% sodium chloride solution. The rate of intravenous infusion is 20-40 drops per minute.

For cesarean section, oxytocin is injected into the uterine muscle at a dose of 5 IU.

For gynecological indications - subcutaneously or intramuscularly at a dose of 5-10 IU.

Application Features:

The use of the drug is contraindicated in the presence of a history of hypersensitivity to oxytocin.

Except in special cases, the use of oxytocin is not recommended in preterm labor; with a significant degree of narrowing of the pelvis; previous surgery on the uterus or cervix, including after a caesarean section; excessive increase in the tone of the uterus; multiple pregnancy; invasive stages of cervical carcinoma. By the time the fetal head or pelvis is in the pelvic inlet, oxytocin cannot be used to induce labor. It is the doctor's task to identify the so-called special cases due to the combination of various factors. Before proceeding with the use of oxytocin, the expected positive effects of therapy should be compared with the risks (although rarely, hypertonicity and uterus are possible).

In order to induce labor and enhance the contractile activity of the uterus, oxytocin is used exclusively intravenously, in a hospital, and under medical supervision. Each patient who receives an infusion of oxytocin should be under the constant supervision of a physician who is familiar with the drug and its side effects. A specialist doctor who has undergone special training should be nearby in case of development of side effects.

To avoid complications, you should constantly monitor the contractions of the uterus, the cardiac activity of the woman in labor and the fetus, the blood pressure of the woman in labor. At the first sign of uterine hyperactivity, the administration of oxytocin should be stopped immediately; as a result, the uterine contractions caused by the drug, as a rule, soon disappear.

When used adequately, oxytocin induces uterine contractions similar to normal childbirth. Excessive stimulation, which occurs when the drug is used incorrectly, is dangerous for both the woman in labor and the fetus.

It must be borne in mind that in cases of hypersensitivity to the drug, hypertensive contractions are possible even with adequate use of the drug. Consideration should be given to the possibility of increased bleeding and the development of afibrinogenemia.

The antidiuretic effect of the drug favors water retention in the body. The possibility of overhydration should be given special attention when using a constant infusion of oxytocin and taking liquids inside.

When administered parenterally, the drug is used either only intravenously or only intramuscularly.

There are cases of death in parturient women as a result of hypersensitivity reactions, as well as cases of fetal death for various reasons with the parenteral use of the drug to induce labor and stimulate uterine contractions.

Side effects:

For women in labor:

From the reproductive system: large doses or hypersensitivity to the drug can cause arterial hypertension, spasms, tetany and uterine rupture; increased bleeding in the postpartum period due to afibrinogenemia and hypoprothrombinemia. Sometimes a small pelvis is possible. It is possible to achieve a reduction in the risk of bleeding in the postpartum period by systematically monitoring the course of labor.

From the side of cardio-vascular system: the use of large doses of oxytocin can cause arrhythmias, premature ventricular contractions, arterial hypertension following arterial hypotension, reflex tachycardia, bradycardia.

From the side digestive system: , .

From the side of water and electrolyte metabolism: due to the antidiuretic effect of oxytocin, with its rapid intravenous administration (more than 40 drops / min), along with a large amount of liquid, severe hyperhydration is possible. The state of severe hyperhydration with convulsions and coma can also develop with a slow, more than

24-hour infusion of oxytocin.

From the side immune system: anaphylactic reactions associated with dyspnea, hypotension or shock; anaphylaxis and others allergic reactions; occasionally - lethal outcome.

From the side nervous system: .

From the skin: rashes on the skin.

In the fetus or newborn: a low Apgar score as determined 5 minutes after birth, neonatal jaundice, retinal hemorrhage in newborns.

In cases of severe toxemia or weak contractile labor activity of the uterus, long-term use of oxytocin is contraindicated.

Overdose:

Symptoms overdoses depend mainly on the degree of sensitivity of the uterus to oxytocin and are not associated with the presence of hypersensitivity to the active component of the drug. Hyperstimulation can lead to strong (hypertonic) and prolonged (tetanic) contractions, or to rapid labor with a characteristic base tone of 15-20 mm aq. Art. and more, which are measured between two contractions, and can also cause rupture of the body or cervix, vagina, bleeding in the postpartum period, utero-placental hypoperfusion, slowing of fetal cardiac activity, hypoxia, hypercapnia and fetal death.

Long-term use of the drug in large doses (40-50 ml / min) may be accompanied by a severe side effect - hyperhydration, which is due to the antidiuretic effect of oxytocin.

Treatment consists in stopping the infusion of oxytocin, limiting fluid intake, using diuretics, intravenous administration of hypertonic saline, correcting electrolyte balance, stopping with barbiturates, and providing professional care for a patient who is in a coma.

Storage conditions:

To store in the place protected from light at a temperature from 8 °C to 15 °C.

Leave conditions:

On prescription

Package:

A drug that increases the tone and contractile activity of the myometrium

Active substance

Oxytocin (oxytocin)

Release form, composition and packaging

Solution for infusions and intramuscular injections colorless, transparent.

Excipients: glacial acetic acid - 2.0 mg, chlorobutanol hemihydrate - 3 mg, ethanol 96% - 40 mg, water for injection - up to 1 ml.

1 ml - glass ampoules (5) - contour plastic packaging (1) - cardboard packs.

pharmachologic effect

Synthetic hormonal drug. In terms of pharmacological and clinical properties, it is similar to endogenous oxytocin in the posterior pituitary gland. Interacts with oxytocin-specific receptors in the uterine myometrium, belonging to the G-protein superfamily. The number of receptors and the response to the action of oxytocin increase as pregnancy progresses and reach a maximum towards its end. It stimulates the labor activity of the uterus by increasing the permeability of cell membranes for calcium ions and increasing its intracellular concentration, followed by a decrease in the resting potential of the membrane and an increase in its excitability. Causes contractions similar to normal spontaneous childbirth, temporarily impairing the blood supply to the uterus. With an increase in the amplitude and duration of muscle contractions, the uterine os expands and smoothes. In appropriate quantities, it can increase the contractility of the uterus from moderate in strength and frequency, characteristic of spontaneous motor activity, to the level of prolonged tetanic contractions.

Causes contraction of myoepithelial cells adjacent to the alveoli of the mammary gland, improving the secretion of breast milk.

By acting on the smooth muscles of the vessels, it causes vasodilation and increases blood flow in the kidneys, coronary vessels and cerebral vessels. Usually, blood pressure remains unchanged, however, when administered intravenously in high doses or a concentrated solution of oxytocin, blood pressure may temporarily decrease with the development of reflex tachycardia and a reflex increase in ejection. Following the initial decrease in blood pressure, a prolonged, albeit slight, increase follows.

Unlike vasopressin, oxytocin has a minimal antidiuretic effect, however, overhydration is possible when oxytocin is administered with large amounts of electrolyte-free solutions and / or if they are administered too quickly. Does not cause muscle contraction Bladder and intestines.

Pharmacokinetics

With intravenous administration, the effect of oxytocin on the uterus appears almost instantly and lasts for 1 hour. With intramuscular administration, the myotonic effect occurs in the first 3-7 minutes and lasts for 2-3 hours.

Like vasopressin, oxytocin is distributed throughout the extracellular space. Small amounts of oxytocin appear to enter the fetal circulation. T 1/2 is 1-6 minutes and becomes shorter in late pregnancy and lactation. Most of the drug is rapidly metabolized in the liver and kidneys. In the process of enzymatic hydrolysis, it is inactivated, primarily under the action of tissue oxytokinase (oxytokinase is also found in the placenta and). Only a small amount of oxytocin is excreted unchanged by the kidneys.

Indications

- for labor induction and stimulation of labor activity (primary and secondary weakness of labor activity; the need for early delivery due to preeclampsia, Rhesus conflict, intrauterine fetal death; post-term pregnancy; premature discharge of amniotic fluid, labor in breech presentation);

- for the prevention and treatment of hypotonic uterine bleeding after an abortion (including with long pregnancy);

- in the early postpartum period to accelerate the postpartum involution of the uterus;

- to reduce the uterus during caesarean section (after removal of the placenta).

Contraindications

- narrow pelvis (anatomical and clinical);

- transverse or oblique position of the fetus;

- facial presentation of the fetus;

- premature birth;

- threatening uterine rupture;

- scars on the uterus (after a previous caesarean section, operations on the uterus);

- excessive stretching of the uterus;

- uterus after multiple births;

- partial placenta previa;

- uterine sepsis;

- invasive carcinoma of the cervix;

- uterine hypertonicity (which did not occur during childbirth);

- chronic kidney failure;

- Hypersensitivity to the components of the drug.

Dosage

In / in or in / m.

In order to induce and enhance labor activity, oxytocin is used exclusively in / in, in a hospital, under appropriate medical supervision. The simultaneous use of the drug in / in and / m is contraindicated. The dose is selected taking into account the individual sensitivity of the pregnant woman and the fetus.

For induction and stimulation of labor Oxytocin is used exclusively in the form of an intravenous drip infusion. Strict control of the prescribed infusion rate is essential. The safe use of oxytocin during induction and intensification of labor requires the use of an infusion pump or other similar device, as well as monitoring the strength of uterine contractions and fetal cardiac activity. In the event of an excessive increase in the contractile activity of the uterus, the infusion should be stopped immediately, as a result, the excess muscle activity of the uterus quickly decreases.

1. Before proceeding with the administration of the drug, you should begin to inject a saline solution that does not contain oxytocin.

2. To prepare a standard infusion of oxytocin in 1000 ml of non-hydrating liquid, dissolve 1 ml (5 IU) of oxytocin and mix thoroughly by swirling the vial. In 1 ml of the infusion prepared in this way contains 5 honey of oxytocin. For accurate dosing of the infusion solution, an infusion pump or other similar device should be used.

3. The rate of administration of the initial dose should not exceed 0.5-4 mU / min, which corresponds to 2-16 drops / min, because 1 drop of infusion contains 0.25 honey of oxytocin). Every 20-40 minutes it can be increased by 1-2 mU / min until the desired degree of contractile activity of the uterus is reached. Upon reaching the desired frequency of uterine contractions, corresponding to spontaneous labor, and with the opening of the cervix of the uterus up to 4-6 cm, in the absence of signs of fetal distress, the infusion rate can be gradually reduced at a pace similar to its acceleration.

In late pregnancy, infusion at a higher rate requires caution, only in rare cases may a rate exceeding 8-9 mU / min be required. In the case of preterm labor, a high rate may be required, which in rare cases may exceed 20 mU / min (80 drops / min).

1. Fetal heart rate, uterine tone at rest, frequency, duration and strength of its contractions should be monitored.

2. In case of uterine hyperactivity or fetal distress, oxytocin administration should be stopped immediately and oxygen therapy should be provided to the woman in labor. The condition of the woman in labor and the fetus should be re-checked by a specialist doctor.

Prevention and treatment of hypotonic bleeding in the postpartum period

1. In / in drip infusion: dissolve 10-40 IU of oxytocin in 1000 ml of non-hydrating liquid; for the prevention of uterine atony, 20-40 mU / min of oxytocin is usually needed.

2. In / m administration: 5 IU / ml of oxytocin after separation of the placenta.

Incomplete or missed abortion

Add 10 IU/ml of oxytocin to 500 ml of saline or a mixture of 5% with saline. The rate of intravenous infusion is 20-40 drops / min.

Side effects

At women in labor

From the side reproductive system: at high doses or hypersensitivity - uterine hypertonicity, spasm, tetany, uterine rupture; increased bleeding in the postpartum period as a result of oxytocin-induced thrombocytopenia, afibrinogenemia and hypoprothrombinemia, sometimes hemorrhages in the pelvic organs. With careful medical supervision during childbirth, the risk of bleeding in the postpartum period is reduced.

From the side of the cardiovascular system: when used in high doses - arrhythmia, ventricular extrasystole, severe arterial hypertension (in the case of the use of vasopressor drugs), arterial hypotension (when used simultaneously with the anesthetic cyclopropane), reflex tachycardia, shock, if administered too quickly - bradycardia, subarachnoid hemorrhage.

From the digestive system: nausea, vomiting.

From the side of water-electrolyte metabolism: severe overhydration with prolonged intravenous administration (usually at a rate of 40-50 mU / min) with a large amount of fluid (antidiuretic effect of oxytocin), can also occur with a 24-hour slow infusion of oxytocin, accompanied by convulsions and coma; rarely - lethal outcome.

Allergic reactions: anaphylaxis and other allergic reactions, with too rapid administration of bronchospasm; rarely - lethal outcome.

In a fetus or newborn

As a result of the introduction of oxytocin to the mother - within 5 minutes, a low Apgar score, neonatal jaundice, if administered too quickly - a decrease in the level of fibrinogen in the blood, hemorrhage in the retina of the eye; as a result of increased contractile activity of the uterus - sinus bradycardia, tachycardia, ventricular extrasystole and other arrhythmias, changes in the central nervous system, fetal death as a result of asphyxia.

Overdose

Symptoms depend mainly on the degree of hyperactivity of the uterus, regardless of the presence of hypersensitivity to the drug. Hyperstimulation with hypertonic and tetanic contractions or with basal tone ≥15-20 mm aq. Art. between two contractions leads to discoordination of labor, rupture of the body or cervix, vagina, bleeding in the postpartum period, uteroplacental insufficiency, fetal bradycardia, hypoxia, hypercapnia, compression, or death. Hyperhydration with convulsions as a result of the antidiuretic effect of oxytocin is a serious complication and develops with prolonged administration of the drug at high doses (40-50 ml / min).

Treatment hyperhydration: withdrawal of oxytocin, restriction of fluid intake, use of diuretics to force diuresis, intravenous administration of hypertonic saline, correction of electrolyte imbalance, relief of seizures with appropriate doses of barbiturates, and careful care of the patient in a coma.

drug interaction

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

When anesthesia with cyclopropane, it is possible to change the cardiovascular action of oxytocin with the unforeseen development of arterial hypotension, sinus bradycardia and AV rhythm in the parturient woman during anesthesia.

special instructions

Until the fetal head is inserted into the pelvic inlet, oxytocin cannot be used to stimulate labor.

Before proceeding with the use of oxytocin, the expected benefit of therapy should be weighed against the possibility, albeit small, of the development of hypertension and tetany of the uterus.

Each patient receiving intravenous oxytocin should be in the hospital under the constant supervision of experienced professionals experienced in the use of the drug and the recognition of complications. If necessary, the immediate assistance of a medical specialist should be provided. In order to avoid complications during the use of the drug, uterine contractions, the cardiac activity of the woman in labor and the fetus, and the blood pressure of the woman in labor should be constantly monitored. With signs of uterine hyperactivity, the administration of oxytocin should be stopped immediately, as a result of which the uterine contractions caused by the drug usually subside soon.

With adequate use, oxytocin causes uterine contractions similar to spontaneous childbirth. Excessive stimulation of the uterus with improper use of the drug is dangerous for both the woman in labor and the fetus. Even with adequate use of the drug and appropriate monitoring, hypertensive uterine contractions occur with increased sensitivity of the uterus to oxytocin.

The risk of developing afibrinogenemia and increased blood loss should be taken into account.

There are known cases of death of a woman in labor as a result of hypersensitivity reactions, subarachnoid hemorrhage, uterine rupture and fetal death due to various reasons associated with the parenteral administration of a drug for the induction of labor and the stimulation of labor in the first and second stages of labor.

As a result of the antidiuretic effect of oxytocin, hyperhydration may develop, especially with the use of a constant infusion of oxytocin and oral fluid intake.

The drug can be diluted in solutions of sodium lactate, and glucose. Ready solution should be used in the first 8 hours after its preparation. Compatibility studies were conducted with 500 ml infusions.

Influence on the ability to manage vehicles and mechanisms

Oxytocin does not affect the ability to drive a car and mechanisms, work on which is associated with an increased risk of injury.

Pregnancy and lactation

In the first trimester of pregnancy, oxytocin is used only for spontaneous or induced abortions. Numerous data on the use of oxytocin, its chemical structure and pharmacological properties indicate that, if the recommendations are followed, the likelihood of an effect of oxytocin on an increase in the incidence of fetal malformations is small.

Small amounts are excreted in breast milk.

When using the drug to stop uterine bleeding, breastfeeding can only be started after the completion of the course of treatment with oxytocin.

For impaired renal function

Contraindicated in chronic renal failure.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored out of the reach of children, protected from light at a temperature of 2° to 15°C. Shelf life - 3 years. Do not use the drug after the expiration date.

Obstetrics. Gynecology

Description

Solution for injection and topical application 5 IU/ml

Pharmacotherapeutic group

Labor activity stimulant-drug oxytocin

Tradename

Oxytocin

International non-proprietary name

Oxytocin

Dosage form

Solution for injection and topical application

Compound

per 1 ml: Active substance: synthetic oxytocin - 5 IU. Excipients: chlorobutanol hemihydrate (chlorobutanol hydrate), acetic acid, water for injection - up to 1 ml.

ATX code

Pharmacological properties

A hormonal agent, a polypeptide analogue of the hormone of the posterior pituitary gland. It has uterotonic, stimulating labor and lactotropic action. It has a stimulating effect on the smooth muscles of the uterus, increases the contractile activity of the myometrium and, to a lesser extent, tone (especially at the end of pregnancy, during labor and directly during delivery). Under the influence of oxytocin, the permeability of cell membranes for calcium ions Ca2+ increases, the resting potential decreases and their excitability increases (a decrease in the membrane potential leads to an increase in the frequency, intensity and duration of contractions). In small doses, oxytocin increases the frequency and amplitude of uterine contractions, in large doses or with repeated administration, it increases the tone of the uterus, increases and intensifies its contractions (up to tetanic). Stimulates the secretion of breast milk, increasing the production of prolactin by the anterior pituitary gland. Reduces myoepithelial cells around the alveoli of the mammary gland, stimulates the flow of milk into large ducts or sinuses, contributing to increased milk separation. Virtually devoid of vasoconstrictor and antidiuretic action (shows them only in high doses), does not cause contraction of the muscles of the bladder and intestines. With intramuscular and subcutaneous administration of the drug, the effect occurs after 1-2 minutes and lasts 20-30 minutes; when administered intravenously, the effect occurs after 0.5-1 min; when administered intranasally, the effect occurs within a few minutes.

Pharmacokinetics

The half-life is 1-6 minutes (decreases in late pregnancy and lactation). Communication with plasma proteins is low (30%). Well absorbed through the nasal mucosa. Metabolized in the liver and kidneys. During pregnancy, the concentration of oxytocinase, which inactivates endogenous and exogenous oxytocin, increases in plasma, target organs, and the placenta. Excretion mainly by the kidneys unchanged.

Indications for use

For excitation and stimulation of labor activity (primary and secondary weakness of labor activity, the need for early delivery due to preeclampsia, Rhesus conflict, intrauterine fetal death; post-term pregnancy, premature discharge of amniotic fluid, delivery in breech presentation).
For the prevention and treatment of hypotonic uterine bleeding after an abortion (including long-term pregnancy), in the early postpartum period and to accelerate postpartum uterine involution; to enhance the contractility of the uterus during caesarean section (after removal of the placenta).
Hypolactation in the postpartum period.
Painful premenstrual syndrome, accompanied by edema, weight gain.

Contraindications

Hypersensitivity; narrow pelvis (anatomical and clinical), transverse and oblique position of the fetus, facial presentation of the fetus, preterm labor, threatened uterine rupture, scars on the uterus (after a previous caesarean section, uterine surgery), excessive uterine distension, uterus after multiple births, partial placenta previa, uterine sepsis, invasive cervical carcinoma; uterine hypertonicity (which did not occur during childbirth), fetal compression, arterial hypertension, chronic renal failure.

Application during pregnancy

Not specified.

Dosage and administration

Intravenously (stream slowly and drip), intramuscularly, subcutaneously, into the wall or vaginal part of the cervix, intranasally (using a pipette). A single dose for i / m administration, depending on the clinical situation, usually varies from 2 to 10 IU (from 0.4 to 2 ml); for intravenous administration (stream slowly or drip), a single dose is usually 5-10 IU (1-2 ml).
To induce labor - in / m, 0.5-2 IU (0.1-0.4 ml of the drug); if necessary, repeat injections every 30-60 minutes.
Induction of labor: intravenous drip, 10 IU of oxytocin (2 ml of the drug) per 1 liter of 5% dextrose (glucose) solution, with the development of excessive uterine contractions, slowing down the infusion quickly leads to a decrease in myometrial activity. The introduction begins with 5-8 drops / min, followed by an increase in speed, depending on the nature of labor, but not more than 40 drops / min. During the infusion, constant monitoring of uterine activity and the number of fetal heartbeats is necessary.
Abortion on the go: IV drip, 10 IU (2 ml) of oxytocin per 500 ml of 5% dextrose (glucose) solution at a rate of 20-40 drops / min.
For the prevention of hypotonic uterine bleeding, oxytocin is administered intramuscularly, 3-5 IU (0.6-1 ml) 2-3 times a day daily for 2-3 days, it is permissible to introduce 10 IU (2 ml) intramuscularly immediately after separation of the placenta. For the treatment of hypotonic uterine bleeding, 5-8 IU (1-1.6 ml) are administered 2-3 times a day for 3 days. If necessary, 10-40 IU (2-8 ml) of oxytocin dissolved per 100 ml of donor blood is administered intravenously.
Strengthening the separation of milk (to prevent mastitis due to milk stagnation): IM - 2 IU (0.4 ml).
To stimulate lactation in the postpartum period - intranasally or intranasally, 0.5 IU (0.1 ml) 5 minutes before feeding.
During childbirth in breech presentation - 2-5 IU (0.4-1 ml).
During a cesarean section (after removal of the placenta), oxytocin is injected into the wall of the uterus at a dose of 3-5 IU (0.6-1 ml).

Side effect

Bradycardia (in the mother and fetus), lowering blood pressure, shock or increased blood pressure and subarachnoid bleeding, cardiac arrhythmias (including in the fetus); bronchospasm; nausea, vomiting, water retention; neonatal jaundice, a decrease in the concentration of fibrinogen in the fetus, allergic reactions.

Overdose

Symptoms: fetal compression, fetal asphyxia, fetal bradycardia, postpartum hemorrhage, uterine tetanus, uterine rupture, uteroplacental hypoperfusion, hypoxia, hypercapnia, fetal death, fetal birth injuries, water intoxication, convulsions.
Treatment: withdrawal of the drug, reduction of fluid intake, forced diuresis, hypertonic sodium chloride solution, normalization of electrolyte balance, barbiturates (with caution), careful observation.

Recipes 2006

1. Rp: Tab. Ampicillini 0.25

D.t.d. No. 20

S. By 2 tab. 4 r / day for 7-10 days with gestational pyelonephritis.(v-lactam a / b, semi-synthetic broad-spectrum penicillin, aminopenicillin.

2. Rp: Tab. Anaprilini 0.01

D.t.d. No. 20

S. 2 tab. 4-6 times in 30 minutes to stimulate labor.(non-selective in-adrenergic blocker).

3. Rp: Sol. « Baralgin» 5.0

D. t. d. N. 1 inamp.

S. 5 ml IM for labor pain relief.(combination drug, composition: analgin 0.5 g + anticholinergic 5 mg (pitofenone hydrochloride) + ganglion blocker 0.1 mg (feniverin bromide), analgesic and antispastic agent).

4. Rp: Gentamicini sulfatis 0.08

D.t.d. No. 10

S. Dilute in 2 ml of saline i/m 4 r/d in acute salpingitis.

(aminoglycoside a/b, bacteriostatic, acts on Gr+ and Gr-flora, contraindicated in breastfeeding)

5. Rep: Sol. Gyniprali 0.5%-5ml

D.t.d. No. 5 in ampullis

S. 0.5 mg (1 ampoule) diluted in 500 ml of 0.9% saline. r-ra, enter slowly (25 drops / min, if necessary, increase the dose by 5 drops every 5 minutes) with the threat of premature. childbirth in IIItrimester

(v-mimetic, tocolytic)

Rp: Tab. gyniprali 0,00005

D. t. d. № 20

S. Start taking the tablets. 1-2 hours before the end of the infusion: 1 tab. first every 3 hours, and then every 4-6 hours (4-8 times / day) with the threat of premature. childbirth in IIItrimester

(v-mimetic, tocolytic)

6. Rp: Sol. Dexamethazoni 0.4%-1ml

D.t.d. No. 50

S.3 ml intramuscularly after 12 hours for the prevention of SDR in a newborn with a gestational age of 28-34 weeks.

(GCS, accelerates the maturation of the surfactant; the appointment of dexamethasone to accelerate the maturation of the fetal lungs is indicated when preterm labor is performed after 2-3 days, it is dangerous during breastfeeding and pregnancy)

7. Rp: Dragee “ Diane-35” № 21

D. S. Inside, 1 tablet per day, at the same time, starting from the first day of the cycle for 21 days with a break of 7 days as a contraceptive. remedies for polycystic ovary syndrome. (low-dose monophasic COC with antiandrogenic activity, with hyperandrogenic manifestations in women: acne, seborrhea, alopecia, mild hirsutism)

8. Rp: Sol. Dicynoni 12.5%-2ml

D.t.d. No. 10 in ampullis

S. 2-4 ml in/in simultaneously with hemorrhagic shock 1 tbsp.

(angioprotector, increases the image in the walls of vessels in mucopolises of large molecular weight and increases the stability of capillaries, normalizing their permeability during pathological processes, improves microcirculation. The hemostatic effect is associated with an activating effect on the image of thromboplastin, stimulates the formation of a factorIIIfolding, normalization. aggregation Tr., does not affect prothrombin. time, does not have hypercoagulable properties and does not contribute to the formation of blood clots)

9. Rp: Tab. Dopegidi 0.25

D.t.d. No. 20

S. 1 tab. 2 r / day for hypertension in pregnant women, eukinetic type

(neurotropic hypotensive prep. methyldopa of central action, stimulates central alpha2-AR, inhibits sympathetic impulses, which leads to a decrease in blood pressure)

10. Rp: Tab. Duphastoniobductae 0.01

D. t. d. № 10

S. 1 tab. 2 r / day until 16-20 weeks of pregnancy with habitual miscarriage with malformations of the uterus (hypoplasia of the uterus and / or chorion.) 20-40 mg per day.

(synthetic progesterone, the active substance dydrogesterone, promotes the formation of normal secretory endometrium in women after prior estrogen therapy, does not suppress ovulation)

11. Rp: Tab. Indomethacini 0.025 ???????

D.t.d. No. 50

S. 1 tab. 50-100 mg 1 r / day, 7-9 days (total dose should not exceed 1000 mg) with the threat of abortion duringIIandIIItrimester.

The course of treatment can be repeated, but not earlier than after 2 weeks. the fetus has a cumulative effect.

(NSAIDs, a derivative of indolacetic to-you, have. pronounced analgesic. effect. With an increased tone of the uterus, it is the drug of choice, because. is an inhibitor of PG, penetrating the placenta, reduces the tone of the uterus. Allowed up to 32 weeks. Should not be given while breastfeeding. PD - premature. closure art. duct, prolongation of pregnancy)

12. Rp: Tab. Clotrimazoli vaginalis 0.1

D.t.d. No. 20

S. 1 vaginal tab for 10 days with vaginal candidiasis.

(antifungal agent, a derivative of imidazole and triazole, contraindicated inItrimester of pregnancy)

13. Rp: Tab. Clophelini 0.00015

D.t.d. No. 50

S. 1 tab. 2r/day of mild preeclampsia, hypokinetic type of circulation.

(an antihypertensive agent of central action, reduces the effect of adrenergic innervation on the cardiovascular system, reduces the tone of vasomotor centers)

14. Rp: Sol. Methylergometrini 0.02%-1ml

D.t.d. No. 1 in ampullis

S. Dilute 1 ml in 20 ml of saline, intravenously at the same time at the height of the last attempt to prevent bleeding after childbirth

IV 2 ml once in the early postoperative period to prevent bleeding (after CS for PN)

(ergot alkaloid, increases the tone of the myometrium, used for hypotension and atony of the uterus in the early postpartum period, CS, bleeding after abortion)

15. Rp: Tab. Metronidasololi 0.25

D.t.d. No. 20

S. 2 tab. 4 r / day for the treatment of endometritis for 7-10 days

(synthetic a/b, nitroimidazole derivative, contraindicated inItrimester take. and if breastfeeding, use with caution duringIIandIIItrimester take.)

16. Rp: Tab. Nifedipini obductae 0.01

D.t.d. No. 20

S. 1 tab. 2 r / day for mild preeclampsia, eukinetic type of hemodynamics.

(Ca antagonist, antihypertensive, dilates coronary vessels)

17. Rp: Dragee “ Novinet” № 21

D. S. 1 tablet per day, inside at the same time, starting from the first to the fifth day of the cycle for 21 days with a break of 7 days as a contraceptive. funds

(monophasic COOK)

18. Rp: Sol. No-spae 2%-2ml

D. t. d. № 1 inampullis

S. 2 ml IM for labor pain relief.

(reduced form of papaverine, antispasmodic)

19. Rp: Oxytocini5ED-1.0

D. t. d. № 5 inampullis

S. Dilute the contents of the ampoule (1 ml) in 0.9% - 500 ml of saline. solution, start infusion 6-8 drops / min, after 20-30 minutes add 6-8 drops. Max. concentration 40 drops / min - 8 ml / min. For rhodostimulation with weakness of labor activity associated with uterine atony.

(synthetic hormone of the posterior pituitary gland, it is not advisable to inject oxytocin for more than 3-5 hours if it is not effective)

20. Rp: Sol. Promedoli 2% - 1ml

D.t.d. No. 1 in ampullis

S. V / m 1 ml for pain relief in childbirth with the opening of the pharynx by 1.5 - 2 transverse fingers and will satisfy. fetal condition.

(narcotic analgesic, opioid receptor antagonist)

21. Rp: Sol. Progesteroni oleosae1 %-1ml

D. t. d. № 3 inampullis

S. V / m 1 ampoule 1 r / daywithin 2 weeks of ovulation onset for the prevention and treatment of threatened and incipient miscarriage associated with corpus luteum insufficiency

(hormone of the corpus luteum, after fertilization, promotes the transition of the uterine mucosa to the state necessary for the development of a fertilized egg. Reduces the excitability and contractility of the muscles of the uterus and fallopian tubes, stimulates the development of the terminal sections of the mammary glands)

22. Rp: Dragee “ Reguloni” № 21

D. S. 1 tablet per day, inside at the same time, starting from the first day of the cycle for 21 days with a break of 7 days as a contraceptive. funds

(monophasic COC)

23. Rp: Sol. Relanii 0.5 %-2 ml

D. t. d. № 5 inampullis

S. IM 2ml (1 ampoule) for moderate preeclampsia(tranquilizer, benzodiazepine receptor antagonist)

24. Rp: Sol. Refortani 6%-500ml

D. t. d. № 3

S. In / in drip 500 ml 1-2 r / day, the duration of therapy is determined individually, in case of violation it will reduce. the ability of the uterus in the early postpartum. period with blood loss exceeding 0.5% of body weight (350-400 ml)

(HES, plasma-substituting drug)

25. Rp: Sol. Magnesium sulfatis 25%-2 0ml

D. t. d. № 10 inampullis

S. Loading dose: in / in 1 bottle (5 g) diluted in 100-200 ml of 0.9% saline. solution or HES; then a maintenance dose depending on body weight: up to 60 kg - 1 g / h, 65-70 kg - 2 g / h, more than 70 kg - 2-3 g / h for labor pain relief or for the treatment of PE

(antihypertensive drug, antispasmodic, anticonvulsant, sedative effect)

26. Rp: GelCerviprosti 0.07% – 3 ml

D. S. For maturation of the cervix 1.5 ml into the posterior fornix of the vagina (1 syringe)

(PG E2, a means that promotes the maturation of the cervix and enhances the contractile activity of the myometrium)

27. Rp: Cephazolini 0.5

D.t.d. No. 10

S. Dilute the contents of the vial in 3 ml isot. solution, i / m deep into the muscle 1 bottle 3-4 r / day for lactation mastitis.

(1st generation cephalosporin, dangerous during pregnancy and breastfeeding)

28. Rp: Sol. Infucoli 6%-500

D. t. d. № 1

S

2 9 . Rep: Sol. Stabisoli 6%-500

D. t. d. № 1

S. For circulating blood volume in case of bleeding

30. Rp: Dragee “Sorbifer durules” #100

D. S. 1 tablet 2 times a day for the treatment of anemia

(ferrous sulfate/ascorbic acid)

In 1 ml of oxytocin solution 5 IU.

Chlorobutanol, acetic acid solution, water - as excipients.

Release form

Solution for injection in ampoules of 5 IU per 1 ml.

pharmachologic effect

Stimulating labor activity .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

What is Oxytocin? Wikipedia gives this definition: oxytocin is a hormone hypothalamus . Here the hormone is produced and along the axons of neurons of the hypothalamic-pituitary tract enters the posterior lobe pituitary gland which serves as a reservoir.

The hormone oxytocin is a protein. It has the ability to stimulate uterine muscle contractions at the end of pregnancy and the entire period of labor until delivery. In general, it regulates behavioral responses associated with pregnancy and childbirth.

Currently obtained synthetically. Synthetic, unlike natural, does not contain impurities of other hormones, therefore, it has a more selective effect on the myometrium. Since the drug is free of proteins, it can be used intravenously without fear of anaphylactic action. The mechanism of action is related to the effect on cells myometrium : increases the permeability of membranes for potassium ions and increases excitability. Increases the frequency and duration of uterine contractions. Stimulates the secretion of milk, increasing the production of the hormone (lactogenic hormone) and increasing the contraction of lactating mammary gland cells. It has an unexpressed antidiuretic effect. Virtually no effect on blood pressure.

Pharmacokinetics

After intravenous administration, the effect appears immediately and gradually decreases (up to 1 hour), with intramuscular administration, the effect appears after 3-5 minutes and lasts from 30 minutes to 3 hours. The effect is individual, which is explained by the density of oxytocin receptors in the muscle cells of the uterus. Rapidly absorbed into the bloodstream through the nasal mucosa. Communication with proteins about 30%. T ½ 1-6 minutes, this period is shortened in late pregnancy and during breastfeeding. Metabolized in the liver and kidneys. Excreted by the kidneys.

Indications for use

• excitation and stimulation of labor ;
• labor induction for medical reasons ( Rhesus conflict , , post-term pregnancy , intrauterine fetal death, premature discharge of water);
• prevention of bleeding after or after scraping;
• incomplete abortion ;
• acceleration of uterine contraction in the early postpartum period;
• increased uterine contraction (injection is performed after removal of the placenta);
• premenstrual syndrome, which is accompanied by swelling and weight gain;
• hypolactation after childbirth.

Contraindications

• hypersensitivity;
• high blood pressure ;
• severe disorders of the cardiovascular system;
• threatening uterine rupture ;
• discrepancy between the size of the fetus and the pelvis of the woman in labor;
• the presence of postoperative scars on the uterus;
• transverse and oblique position of the fetus;
• narrow pelvis;
• suspicion of placental abruption before the time;
• placenta previa;
• intrauterine fetal hypoxia ;
• hypertonic uterine contractions;
• heavy preeclamptic toxemia .

Side effects

• nausea, vomiting;
• allergic reactions;
• and bradycardia;
• increase in blood pressure;
• urinary retention;
• excessive labor activity, which leads to premature detachment of the placenta and the risk of uterine rupture;
• subarachnoid bleeding e;
• decline fibrinogen in the fetus;
• neonatal jaundice .

Oxytocin injections, instructions for use (Method and dosage)

The drug in the form of injections is administered intravenously or intramuscularly.

Instructions for use Oxytocin

Oxytocin during childbirth in order to induce labor is used intramuscularly 0.5-2.0 IU. Injections can be repeated every 30-60 minutes. If there is a need for drip administration of the drug, then 1 ml (5 IU) is diluted in 500 ml of 5% glucose solution. First, it is administered at a rate of 5-8 drops per minute, then, depending on labor activity, the rate is increased to a maximum of 40 drops per minute.

With the aim of prevention of bleeding after childbirth on the first day appoint intramuscularly 5 - 8 IU three times a day for 3 days. During a cesarean section, injections are made into the wall of the uterus 3-5 IU (after the extraction of the fetus). An overdose of oxytocin during childbirth can cause neonatal jaundice due to drug hemolysis .

Instructions for use for animals

There is a veterinary drug that contains 5 or 10 units in 1 ml oxytocin . In veterinary medicine, it is used for prolonged labor in animals, retained placenta, postpartum uterine bleeding, for the treatment endometritis , agalactia (lack of milk) and mastitis .

One time use: dogs administered - 5-10 units depending on weight, cats - 2-3 units. For a quick effect, intravenous administration is practiced in a glucose solution, in which case the dose is reduced by 30%. Repeated administration is possible, however, the reaction to the drug decreases with each administration.

Oxytocin for abortion

Oxytocin has abortive action -causes contractions and provokes a miscarriage. Its use for this purpose is permissible for up to 4-5 weeks, but more often gynecologists use and .

Oxytocin is also used in pregnancy from 14 weeks during the execution induced abortion for medical reasons (missed pregnancy, malformations in a child). The drug is injected into the cervical region after taking Mifepristone and Misoprostol if the miscarriage was not complete or with incomplete spontaneous miscarriage, but intravenous infusions are more often performed. However, in the second trimester, the drug often causes uterine hypertonicity . Even with adequate use, hypertonic contractions of the uterus can occur with its increased sensitivity to oxytocin.

medical abortion is carried out only in a medical institution under the supervision of a doctor, control of the contractile function of the uterus and the general condition of the woman. The doctor must make sure that the fetal egg has come out of the uterine cavity. In addition, the procedure is dangerous due to the occurrence of bleeding.

The dosage of Oxytocin for abortion is determined by the doctor, since the frequency of uterine contractions and their duration depend on it. Women who have , malformations of the uterus , scars on the neck abortion Oxytocin contraindicated.

Overdose

It is manifested by symptoms of hyperstimulation of the uterus, which leads to tetanic contractions, its rupture, bleeding. The fetus has bradycardia , hypoxia and asphyxia , birth trauma.

If symptoms of an overdose appear, the administration of the drug is urgently stopped, the fluid intake is reduced, diuretics, hypertonic saline solutions, barbiturates are prescribed.

Interaction

The drug potentiates the vasoconstrictor effect of sympathomimetics. Use with caution with and as the risk increases arterial hypotension .

Inhalants for weaken its effect on the uterus. Prostaglandins enhance its stimulating effect. Use with MAO inhibitors poses a risk arterial hypertension .

Terms of sale

Released by prescription.

Storage conditions

At a temperature of 4-15 ° C.

Best before date

Analogues

Oxytocin-Vial , Oxytocin-Ferein , Oxytocin-Grindeks , Oxytocin-Richter , Oxytocin-MEZ , Pitocin , Syntocinon .

Vasopressin and Oxytocin

This is also a hormone synthesized by the neurons of the nuclei of the hypothalamus, like oxytocin. In their structure, they have much in common, but they have different physiological effects. vasopressin, or antidiuretic hormone , renders antidiuretic and vasoconstrictive effects . The main function is to increase the reabsorption of water in the kidneys during a decrease in blood pressure or blood volume.

Reviews about Oxytocin

Oxytocin - what is it? Oxytocin is the “hormone of love”, it is not for nothing that it is called that, since an increased level is determined in women and men during the period of falling in love. It helps to strengthen emotional and sexual attachment and tenderness between members of different sexes. This has been repeatedly proven in studies: the injection of a nasal spray leads to an increase in sexual desire, an improvement in sexual life. In addition, it is called the "elixir of confidence." Persons with elevated levels of this hormone tend to trust other people, become more kind and open.

Especially high level The hormone is produced in women at the time of the birth of a child - this condition can be called the "explosion of oxytocin". So, when feeding, oxytocin is produced, since the sucking reflex contributes to its formation. This accelerates the contraction of the uterus and reduces the risk of postpartum hemorrhage. The hormone helps to strengthen the bond between mother and baby and causes maternal instinct, increased caring and tenderness towards the child. A slightly smaller "explosion" of oxytocin is observed during orgasm.

An interesting fact is that a nasal spray containing oxytocin reduces appetite and cravings for fatty foods. The researchers found that after applying the spray, the volunteers consumed less food. Currently, studies are ongoing on the effect of oxytocin on the activity of the brain of autistic children. Since activation of those areas of the brain that are oppressed in these children was found.

Another study noted a similar effect of alcohol and oxytocin on human behavior. acting on different receptors, they cause similar changes in GABA in the limbic structures that are responsible for the perception of stress and anxiety. This hormone reduces the feeling of anxiety and fear, and on the other hand, it provokes rash acts, causes aggressive and risky behavior.

What foods contain oxytocin? Can it be replenished by eating? The hormone oxytocin is not found in food, so it does not enter the body from the outside. It has only been established that the use of dates stimulates its synthesis during pregnancy and childbirth. Reception of dates, which contain more than 10 elements, a large amount of fructose, is recommended a few days before childbirth. Stimulate the release of this hormone by stroking and hugging, the pleasant voice of a partner, massage of the feet, earlobes.

For many years, the drug has been the most effective for stimulating weak labor, treating uterine bleeding, with medical termination of pregnancy, therefore it is often used in obstetric and gynecological practice. Analyzing the reviews, we can conclude that the drug was indeed prescribed to many during and after childbirth. Some women noted a sharp increase in contractions and, accordingly, pain, and some "did not respond" to the administration of the drug - this depends on individual sensitivity.

Now that we have sorted out what it is, we learned about indications, contraindications and side effects its like a drug, it must be said that to experiment at home and try to disrupt an early pregnancy Oxytocin not safe. In fact, this is a criminal abortion, and the consequences of using the drug for this purpose are unpredictable: loss of childbearing function, bleeding of varying degrees, and even death. In addition, it is not possible to purchase this drug in a pharmacy, since a prescription in Latin written by a doctor is needed. For the sake of your health, use legal abortion methods!

This drug is used for animals, and in this case you need to know what dosages are used in veterinary medicine. This is often asked questions on the forums. There are general rules for the use of the drug. It is used only after the birth of the first puppy or kitten, when the cervix is ​​open, otherwise it can cause uterine rupture. If it does not work, you can not do a second dose. It is contraindicated to hasten labor by giving injections after the birth of each puppy. It is not recommended to give injections if the dog is pushing to no avail, and you suspect that the puppy is "stuck". During childbirth, 0.3-0.4 ml is administered intramuscularly to a cat, if there is weakness in labor and prolonged labor, there are doubts that not all kittens were born. If the drug was not used during childbirth, it is administered after the end of childbirth at a dose of 0.3 ml. The dosage for dogs is 1-2 ml, depending on the weight.

Oxytocin price, where to buy

You can buy the drug in Moscow at any pharmacy. The price of ampoules of Oxytocin 5 IU 1 ml No. 5 ranges from 54 rubles. up to 65 rubles Buy spray as well Oxytocin in tablets (it is represented by the drug Deaminooxytocin , Demoxytocin , Sandopart ) is currently not possible.