Individual generic drug information

oxytocin

Reference monograph

Part of registered formulation

OXYTOCIN

Reference record: Oxytocin
Source: BNF 80 (2020–2021)
Printed source pages: 890, 891
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Oxytocin only.

Indications And Dose

Induction of labour for medical reasons | Stimulation of labour in hypotonic uterine inertia ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 0.001–0.004 unit/minute, not to be started for at least 6 hours after administration of vaginal prostaglandin, dose increased at intervals of at least 30 minutes until a maximum 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 INTRAVENOUS INJECTION ▶Adult: 5 units immediately after delivery Prevention of postpartum haemorrhage after delivery of placenta ▶BY SLOW INTRAVENOUS INJECTION ▶Adult: 5 units, if infusion previously used for induction or enhancement of labour, increase rate during third stage and for next few hours ▶BY INTRAMUSCULAR INJECTION ▶Adult: 10 units, can be used instead of oxytocin with ergometrine (Syntometrine ®). Treatment of postpartum haemorrhage ▶BY SLOW INTRAVENOUS INJECTION ▶Adult: 5 units, repeated if necessary Treatment of severe cases of postpartum haemorrhage (following intravenous injection) ▶BY INTRAVENOUS INFUSION ▶Adult: 40 units, given in 500 mL infusion ﬂuid given at a rate sufﬁcient to control uterine atony Incomplete, inevitable, or missed miscarriage ▶INITIALLY BY SLOW INTRAVENOUS INJECTION ▶Adult: 5 units, followed by (by intravenous infusion) 0.02–0.04 unit/minute if required, the rate of infusion can be faster if necessary l UNLICENSED USE Oxytocin doses in the BNF may differ from those in the product literature. Administration by intramuscular injection is an unlicensed use.

Source page 890

Contra Indications

Any condition where spontaneous labour inadvisable. any condition where vaginal delivery inadvisable. avoid intravenous injection during labour. avoid prolonged administration in oxytocin-resistant uterine inertia. avoid rapid intravenous injection (may transiently reduce blood pressure). fetal distress (discontinue immediately if this occurs). hypertonic uterine contractions (discontinue immediately if this occurs). severe cardiovascular disease. severe pre- eclamptic toxaemia

Source page 890

Cautions

Avoid large infusion volumes and restrict ﬂuid intake by mouth (risk of hyponatraemia and water- intoxication). enhancement of labour—presence of borderline cephalopelvic disproportion (avoid if signiﬁcant). history of lower-uterine segment caesarean section. induction of labour—presence of borderline cephalopelvic disproportion (avoid if signiﬁcant). mild pregnancy-induced cardiac disease. mild pregnancy- induced hypertension. moderate pregnancy-induced cardiac disease. moderate pregnancy-induced hypertension. risk factors for disseminated intravascular coagulation. secondary uterine inertia. women over 35 years

Source page 890

Safety

Extracted information for Oxytocin only.

Important Safety Information

Prolonged intravenous administration at high doses with large volume of ﬂuid (which is possible in inevitable or missed miscarriage or postpartum haemorrhage) may cause water intoxication with hyponatraemia. To avoid: manufacturer advises use electrolyte-containing diluent (i.e. not glucose), increase oxytocin concentration to reduce ﬂuid, restrict ﬂuid intake by mouth; monitor ﬂuid and electrolytes.

Source page 890

Side Effects

▶Common or very common Arrhythmias. headache. nausea. vomiting ▶Rare or very rare Dyspnoea. hypotension. rash ▶Frequency not known Angioedema. disseminated intravascular coagulation. electrolyte imbalance. ﬂushing . haemorrhage. myocardial ischaemia. pulmonary oedema . QT interval prolongation. uterine rupture. water intoxication SIDE-EFFECTS, FURTHER INFORMATION Avoid rapid intravenous injection (may transiently reduce blood pressure). Uterine hyperstimulation -usually with excessive doses—may cause fetal distress, asphyxia, and death, or may lead to hypertonicity, tetanic contractions, soft-tissue damage or uterine rupture. Overdose Placental abruption and amniotic ﬂuid embolism reported on overdose.

Source page 890

Monitoring Requirements

▶Careful monitoring of fetal heart rate and uterine motility essential for dose titration. ▶Monitor for disseminated intravascular coagulation after parturition.

Source page 890

Dose and formulations

Extracted information for Oxytocin only.

Directions For Administration

For intravenous infusion (Syntocinon ®), give continuously in Glucose 5% or Sodium chloride 0.9%. Preferably given via a variable-speed infusion pump in a concentration appropriate to the pump; if given by drip infusion for induction or enhancement of labour, dilute 5 units in 500 mL infusion ﬂuid or for higher doses, 10 units in 500 mL; for treatment of postpartum uterine haemorrhage dilute 40 units in 500 mL; if high doses given for prolonged period (e.g. for inevitable or missed abortion or for postpartum haemorrhage), use low volume of an electrolyte- containing infusion ﬂuid (not Glucose 5%) given at higher concentration than for induction or enhancement of labour; close attention to patient’s ﬂuid and electrolyte status essential.

Source page 890

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: infusion, solution for infusion Solution for injection ▶Oxytocin (Non-proprietary) Oxytocin 5 unit per 1 ml Oxytocin 5units/1ml solution for injection ampoules | 5 ampoule P s (Hospital only) Oxytocin 10 unit per 1 ml Oxytocin 10units/1ml solution for infusion ampoules | 5 ampoule P £15.00 | 10 ampoule P £20.00 Oxytocin 10units/1ml concentrate for solution for infusion ampoules | 5 ampoule P £4.55 | 10 ampoule P £9.00 Oxytocin 10units/1ml solution for injection ampoules | 5 ampoule P s (Hospital only) ▶Syntocinon (Mylan) Oxytocin 5 unit per 1 ml Syntocinon 5units/1ml solution for injection ampoules | 5 ampoule P £4.01 (Hospital only) Oxytocin 10 unit per 1 ml Syntocinon 10units/1ml solution for injection ampoules | 5 ampoule P £4.53 (Hospital only) PROSTAGLANDINS AND ANALOGUES

Source page 891

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

Initially 0.001–0.004 unit/minute, not to be

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units immediately after delivery

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units, if infusion previously used for induction

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

10 units, can be used instead of oxytocin with

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units, repeated if necessary

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

40 units, given in 500 mL infusion ﬂuid given at

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units, followed by (by intravenous infusion)

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.

Individual generic drug information

oxytocin

Reference monograph

Part of registered formulation

OXYTOCIN

Reference record: Oxytocin
Source: BNF 80 (2020–2021)
Printed source pages: 890, 891
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Oxytocin only.

Indications And Dose

Source page 890

Contra Indications

Source page 890

Cautions

Source page 890

Safety

Extracted information for Oxytocin only.

Important Safety Information

Source page 890

Side Effects

Source page 890

Monitoring Requirements

▶Careful monitoring of fetal heart rate and uterine motility essential for dose titration. ▶Monitor for disseminated intravascular coagulation after parturition.

Source page 890

Dose and formulations

Extracted information for Oxytocin only.

Directions For Administration

Source page 890

Medicinal Forms

Source page 891

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

Initially 0.001–0.004 unit/minute, not to be

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units immediately after delivery

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units, if infusion previously used for induction

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

10 units, can be used instead of oxytocin with

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units, repeated if necessary

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

40 units, given in 500 mL infusion ﬂuid given at

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Adults

First line only; read the complete Indications and dose section above.

5 units, followed by (by intravenous infusion)

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 890

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.