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Oxytocin

    Brands

    DEA Class; Rx

    Common Brand Names; Pitocin

    • Oxytocic Agents

    Parenteral hormone with all the naturally occurring actions of endogenous oxytocin released from the posterior pituitary
    Used clinically to induce labor and to aid in the delivery of the placenta (third stage of labor)
    Also used to control postpartum bleeding

    Indicated for labor augmentation in patients with a medical necessity for labor induction, at or near to term, when delivery is in the best interests of the mother and the fetus.

    For the management of postpartum bleeding and to produce uterine contractions during the third stage of labor.
    For the adjunctive treatment of inevitable or incomplete abortion.
    For the evaluation of fetal distress using an oxytocin-induced contraction stress test (aka, oxytocin challenge test or CST).

    Significant cephalopelvic disproportion

    Unfavorable fetal positions or presentations, eg, transverse lies,which are undeliverable without conversion prior to delivery

    Obstetric emergencies that favor surgery

    Fetal distress where delivery is not imminent

    Where adequate uterine activity fails to achieve satisfactory progress

    Hyperactive or hypertonic uterus

    Contraindicated vaginal delivery, eg, invasive cervical carcinoma, active herpes genitalis, total placenta previa, vasa previa, & cord presentation or prolapse of cord

    Hypersensitivity

    Fetal distress, polyhydramnios, partial placenta previa, prematurity, borderline cephalopelvic disproportion, previous major surgery of cervix or uterus (incl C-section), overdistension of uterus, grand multiparity, invasive cervical carcinoma, history of uterine sepsis or traumatic delivery

    Hyperstimulation of the uterus, with strong (hypertonic) &/or prolonged (tetanic) contractions, or a resting uterine tone of 15-20 mm H2O between contractions may occur, possibly resulting in uterine rupture, cervical & vaginal lacerations, postpartum hemorrhage, abruptio placentae, impaired uterine blood flow, amniotic fluid embolism, & fetal trauma including intracranial hemorrhage

    Not indicated for elective labor induction

    Sinus bradycardia, tachycardia, premature ventricular complexes & other arrhythmias

    Permanent CNS or brain damage, and death secondary to asphyxia

    Neonatal seizure

    Neonatal jaundice

    Fetal death

    Low Apgar score (5 min)

    Uteroplacental hypoperfusion & variable deceleration of fetal heart rate

    Fetal hypoxia

    Perinatal hepatic necrosis

    Fetal hypercapnia

    Severe decreases in maternal systolic & diastolic blood pressure, increases in heart rate, systemic venous return & cardiac output, & arrhythmia

    If uterine hyperactivity occurs, discontinue immediately

    Intravenous preparations should be be administered by trained personnel

    Risk of severe water intoxication on prolonged administration due to its antidiuretic effects

    Restricting fluid intake may be warranted

    Uterine hypertonicity, spasm, rupture of the uterus, and tetanic contractions may occur from high doses

    IM not recommended for labor induction/augmentation

    Oxytocin injection is used in pregnancy for induction of labor in patients with a medical indication for initiation of labor; stimulation or reinforcement of labor, as in selected cases of uterine inertia

    Not known whether this drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution when oxytocin is administered to nursing woman

    No specific maximum dosage limit recommendations are available. Dosage regimens of oxytocin depend upon the patient’s age, sex, weight, condition being treated, product chosen, and the prescribing clinician’s judgment. Therefore, doses may vary widely and must be carefully individualized.

    Oxytocin

    injectable solution

    • 10 units/mL