Oxytocin

Oxytocin Mode Of Action:
Oxytocin works by increasing the concentration of calcium inside muscle cells that control contraction of the uterus. Increased calcium increases the contraction of the uterus.

Brands of Oxytocin in Kenya

Curtocin® ,Crown Healthcare
Evatocin® , Neon Laboratories Limited
Oxymed® , Medisel Kenya Ltd
Oxytocin® , Umedica Laboratories Pvt Ltd
Oxytocin® , Laborate Pharmaceuticals India Limited
Pabal® , Ferring GmbH Witland Kiel Germany
Sytocinon®, Novartis Pharma Services Inc

INDICATIONS:

Antepartum

  • Induction of labour for medical reasons; e.g. in cases of post-term gestation, premature rupture of the membranes, pregnancy-induced hypertension (pre-eclampsia).
  • Stimulation of labour in hypotonic uterine inertia.
  • Early stages of pregnancy as an adjunctive therapy for the management of incomplete, inevitable, or missed abortion.

Postpartum

  • During caesarean section, but following delivery of the child.
  • Prevention and treatment of postpartum uterine atony and haemorrhage.

CONTRAINDICATIONS:

Hypersensitivity to the active substance or to any of the excipients .
Hypertonic uterine contractions, mechanical obstruction to delivery, foetal distress.
Any condition in which, for foetal or maternal reasons, spontaneous labour is inadvisable and/or vaginal delivery is contra-indicated: e.g.:

  • Significant cephalopelvic disproportion
  • Foetal malpresentation
  • Placenta praevia and vasa praevia
  • Placental abruption
  • Cord presentation or prolapse
  • Overdistension or impaired resistance of the uterus to rupture as in multiple pregnancy
  • Polyhydramnios
  • Grand multiparity
  • In the presence of a uterine scar resulting from major surgery including classical caesarean section.

Oxytocin should not be used for prolonged periods in patients with oxytocin-resistant uterine inertia, severe pre-eclamptic toxaemia or severe cardiovascular disorders.
Oxytocin must not be administered within 6 hours after vaginal prostaglandins have been given .

ADVERSE EFFECTS

The following adverse reactions have been reported in the mother:
Anaphylactic reaction Nausea
Postpartum hemorrhage Vomiting
Cardiac arrhythmia Premature ventricular contractions
Fatal afibrinogenemia Pelvic hematoma
Excessive dosage or hypersensitivity to the drug may result in uterine hypertonicity, spasm, tetanic contraction, or rupture of the uterus.
The possibility of increased blood loss and afibrinogenemia should be kept in mind when administering the drug.
Severe water intoxication with convulsions and coma has occurred, associated with a slow oxytocin infusion over a 24-hour period. Maternal death due to oxytocin-induced water intoxication has been reported.
The following adverse reactions have been reported in the fetus or infant:
(Due to induced uterine motility)
Bradycardia
Premature ventricular contractions and other arrhythmias
Permanent CNS or brain damage
Fetal death
(Due to use of oxytocin in the mother)
Low Apgar scores at five minutes
Neonatal jaundice
Neonatal retinal hemorrhage

DRUG INTERACTIONS:

Prostaglandins and their analogues
Prostaglandins and its analogues facilitate contraction of the myometrium hence oxytocin can potentiate the uterine action of prostaglandins and analogues and vice versa .
Drugs prolonging the QT interval
Oxytocin should be considered as potentially arrhythmogenic, particularly in patients with other risk factors for Torsades de Pointes such as drugs which prolong the QT interval or in patients with history of long QT syndrome .
Interactions to be considered
Inhalation anaesthetics
Inhalation anaesthetics (e.g. cyclopropane, halothane, sevoflurane, desflurane) have a relaxing effect on the uterus and produce a notable inhibition of uterine tone and thereby, may diminish the uterotonic effect of oxytocin. Their concurrent use with oxytocin has also been reported to cause cardiac rhythm disturbances.
Vasoconstrictors/Sympathomimetics
Oxytocin may enhance the vasopressor effects of vasoconstrictors and sympathomimetics, even those contained in local anaesthetics.
Caudal anaesthetics
When given during or after caudal block anaesthesia, oxytocin may potentiate the pressor effect of sympathomimetic vasoconstrictor agents.
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Clinical | Pharmacokinetic data

Pregnancy Category:
Routes of Administration: Intranasal, IV, IM
Bioavailability:
Protein Binding: 30%
Metabolosim: Liver and elsewhere (via oxytocinases)
Onset of Action:
Elimination Half life: 1–6 min (IV) ~2 h (intranasal
Excretion: Biliary and kidney

Legal Status | Dosage forms & Strengths

Prescription Category:
Prescription only Medicine (POM) , ℞-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This Drug is not Subject to DDA drugs Act
Dosage Forms | Strengths:
Injectables

Drug Indentifiers:


Drug Images

References/ Citation:

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