Product Description

Posology

Induction or enhancement of labour: Oxytocin should not be started for 6 hours following administration of vaginal prostaglandins.

Oxytocin should be administered as an intravenous (i.v.) drip infusion or, preferably, by means of a variable-speed infusion pump.

For drip infusion it is recommended that 5 IU (8.3 micrograms) of Oxytocin be added to 500 ml of a physiological electrolyte solution (such as sodium chloride 0.9 %). For patients in whom infusion of sodium chloride must be avoided, 5 % dextrose solution may be used as the diluent (see section 4.4). To ensure even mixing, the bottle or bag must be turned upside down several times before use.

The initial infusion rate should be set at 2 to 8 drops/minute (1 to 4 milliunits/minute). It may be gradually increased at intervals not shorter than 20 minutes and increments of not more than 1 to 2 milliunits/minute, until a contraction pattern similar to that of normal labour is established. In pregnancy near term this can often be achieved with an infusion of less than 20 drops/minute (10 milliunits/minute), and the recommended maximum rate is 40 drops/minute (20 milliunits/minute). In the unusual event that higher rates are required, as may occur in the management of foetal death in utero or for induction of labour at an earlier stage of pregnancy, when the uterus is less sensitive to oxytocin, it is advisable to use a more concentrated oxytocin solution, e.g., 10 IU (16.7 micrograms) in 500 ml. When using a motor-driven infusion pump which delivers smaller volumes than those given by drip infusion, the concentration suitable for infusion within the recommended dosage range must be calculated according to the specifications of the pump.

The frequency, strength, and duration of contractions as well as the foetal heart rate must be carefully monitored throughout the infusion. Once an adequate level of uterine activity is attained, aiming for 3 to 4 contractions every 10 minutes, the infusion rate can often be reduced. In the event of uterine hyperactivity and/or foetal distress, the infusion must be discontinued immediately.

If, in women who are at term or near term, regular contractions are not established after the infusion of a total amount of 5 IU (8.3 micrograms), it is recommended that the attempt to induce labour be ceased; it may be repeated on the following day, starting again from a rate of 2 to 8 drops/minute (1 to 4 milliunits/minute) (see section 4.3).

Incomplete, inevitable, or missed abortion: 5 IU (8.3 micrograms) by i.v. infusion (5 IU diluted in physiological electrolyte solution and administered as an i.v. drip infusion or, preferably, by means of a variable-speed infusion pump over 5 minutes), if necessary followed by i.v. infusion at a rate of 20 to 40 milliunits/minute. Caesarean section: 5 IU (8.3 micrograms) by i.v. infusion (5 IU diluted in physiological electrolyte solution and administered as an i.v. drip infusion or, preferably, by means of a variable-speed infusion pump over 5 minutes) immediately after delivery.

Prevention of postpartum uterine haemorrhage: The usual dose is 5 IU (8.3 micrograms) by i.v. infusion (5 IU diluted in physiological electrolyte solution and administered as an i.v. drip infusion or, preferably, by means of a variable-speed infusion pump over 5 minutes) after delivery of the placenta. In women given oxytocin for induction or enhancement of labour, the infusion should be continued at an increased rate during the third stage of labour and for the next few hours thereafter. Treatment of postpartum uterine haemorrhage: 5 IU (8.3 micrograms) by i.v. infusion (5 IU diluted in physiological electrolyte solution and administered as an i.v. drip infusion or, preferably, by means of a variable-speed infusion pump over 5 minutes), followed in severe cases by i.v. infusion of a solution containing 5 to 20 IU (8.3 to 33.4 micrograms) of oxytocin in 500 ml of an electrolyte-containing diluent, run at the rate necessary to control uterine atony.

Special populations

Renal impairment

No studies have been performed in renally impaired patients.

Hepatic impairment

No studies have been performed in hepatically impaired patients.

Paediatric population

There are no indications for use of Oxytocin in children or adolescents.

Older people (65 years and over)

There are no indications for use of Oxytocin in elderly.

Method of administration Intravenous infusion.