Pregcin

Description

Pregcin Injection, containing Oxytocin, is used for:

• Postpartum haemorrhage
• Labour induction
• Abortion
• Facilitate lactation

It is manufactured by Shiv Pharmaceutical Laboratories and is available in Nepal.

Dosage and Administration

Adults (Intravenous):

• Postpartum Hemorrhage:
  • 10-40 units diluted in 1000 mL of nonhydrating IV solution. Infuse at the necessary rate to control uterine atony. Do not exceed 40 units.
• Labor Induction:
  • Start with 0.5-1 mUnit/min IV.
  • Titrate (increase) by 1-2 mUnit/min every 15-60 minutes until a contraction pattern similar to normal labor is reached (usually 6 mUnits/min).
  • The dose may be decreased after the desired frequency of contraction is reached and labor has progressed to 5-6 cm dilation.
• Incomplete or Inevitable Abortion:
  • 10-20 mUnit/min IV. Do not exceed 30 units per 12 hours.

Child Dose:

• Information not provided in the text.

Special Populations

• Renal Dose:
  • Information not provided in the text.

Important Considerations

• Administration: Intravenous (IV) administration.
• Contraindications: Pregcin is contraindicated in cases of cephalopelvic disproportion, abnormal presentation of the fetus, hydramnios, multiparae, previous cesarean section or other uterine surgery, hyperactive or hypertonic uterus, uterine rupture, contraindicated vaginal delivery (e.g., invasive cervical cancer, active genital herpes, prolapse of the cord, cord presentation, total placenta previa or vasa previa), fetal distress where delivery is not imminent, and severe pre-eclamptic toxemia.
• Precautions: Use with caution in patients with cardiovascular disorders or those over 35 years old.
  • Monitor fetal and maternal heart rate, maternal blood pressure, and uterine motility.
  • Monitor fluid intake and output during treatment.
  • Discontinue immediately if the uterus becomes hypertonic or hyperactive, or if there is fetal distress.
  • Nasal spray use (if applicable) may lead to maternal dependence.
  • Intramuscular (IM) administration is not regularly used due to unpredictable effects.
  • Not to be used for prolonged periods in cases of resistant uterine inertia, severe pre-eclampsia, or severe cardiovascular disorders.
  • Risk of water intoxication exists when used at high doses for prolonged periods.
• Lactation: May be distributed into breast milk. Nursing should be delayed for at least 1 day when the drug is discontinued. Use caution.
• Pregnancy-Lactation: Information on specific recommendations for pregnancy beyond the “Indications” and “Contraindications” is not provided. It is primarily used during labor and for postpartum conditions.
• Interactions:
  • Possible severe hypertension if given within 3-4 hours of a vasoconstrictor in association with caudal block anesthesia.
  • Cyclopropane anesthesia may increase the risk of hypotension and maternal sinus bradycardia with abnormal AV rhythms.
  • Dinoprostone and misoprostol may increase the uterotonic effect of oxytocin, so oxytocin should not be used within 6 hours after administration of vaginal prostaglandins.
  • Concurrent use may increase the vasopressor effect of sympathomimetics.
  • Potentially Fatal: Concomitant use with prostaglandins increases the risk of uterine rupture and cervical lacerations.

Adverse Effects

Side effects of Oxytocin can include:

• Fetus or Neonate: Jaundice; arrhythmias, bradycardia; brain, CNS damage; seizure; retinal hemorrhage; low Apgar score.

• Mother: Transient hypotension, reflex tachycardia; nasal irritation, rhinorrhea, lacrimation (following nasal administration, if applicable); uterine bleeding, violent contractions, hypertonicity; spasm; nausea, vomiting.

• Potentially Fatal: Maternal water intoxication (especially with slow infusion over 24 hours); prolonged uterine contractions causing fetal hypoxia and death; rupture of gravid uterus; afibrinogenemia; subarachnoid hemorrhage.

Mechanism of Action

Oxytocin acts as a uterine stimulant, vasopressor, and has antidiuretic effects. It activates G-protein-coupled receptors that trigger increases in intracellular calcium levels in uterine myofibrils, which results in uterine contractions. It also increases local prostaglandin production, further stimulating uterine contraction.

This information on Pregcin Injection is for general understanding and is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.