ERGOMETRINE
Ergometrine called Ergonovine, is used to cause contractions of the uterus to treat heavy
vaginal bleeding after childbirth. Ergometrine is used widely in obstetrics in the delivery of the
placenta and in preventing bleeding after childbirth. It achieves this by causing the muscle
tissue in the blood vessel walls to narrow which reduces blood flow. Ergometrine is usually used
in combination with oxytocin as a syntometrine. It is also used to induce spasms in the coronary
arteries and to diagnose one of the variant angina. Ergometrine combines ergotamine and
caffeine to prevent and treat migraine headaches. Ergotamine is an ergot alkaloid and works
with caffeine. It prevents the expansion of blood vessels in the head and causing headaches.
Ergometrine is sold under the brand names, Ergonovine, d-lysergic acid, Ergotrate; Ergotrate
Maleate amongst others.
Chemists C Moir and H W Dudley first isolated and obtained it in 1935. It was earlier made from
the rye ergot fungus but can also be made from lysergic acid. Ergometrine is used to make
lysergic acid diethylamide (LSD) and so it is regulated. For its efficacy and life-saving safety
record around the world, it has earned a sot on the World Health Organization's List of Essential
Medicines, the safest and most effective medicines needed in a health system.
Dosage and Administration:
Ergotamine is available as a suppository, sublingual, and a tablet. It sold in combination with
caffeine in some cases. The suppository contains 2 mg of ergotamine with 100 mg caffeine. The
sublingual tablet contains 2 mg of ergotamine in combination with caffeine contains 1 mg of
ergotamine and 100 mg of caffeine. It can be taken by mouth, by injection into a muscle, or as
an injection into a vein.
The Cost of Ergotamine:
In the USA, the average cost for consumers is $144.19 for 10 Tablets of 1-100mg each of the
generic ergotamine-caffeine combination. The cost of this medicine is much lower in the
developing and underdeveloped world. In India, consumers pay USD 0.60 for the same.
How does Ergotamine Work?
Ergotamine acts on alpha-adrenergic, dopaminergic, and serotonin receptors called the 5-HT2
receptor. Its actions affect the uterus and other smooth muscles and stimulate a powerful
stimulant effect not associated with a specific receptor type. By binding selectively and
activating serotonin (5-HT) 1D receptors located on intracranial blood vessels, including on
arterio-venous anastomoses This leads to vasoconstriction and reduction of the blood flow in
cerebral arteries. This eventually gives relief from vascular headaches.
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