Utocin

Description

Utocin Injection (Oxytocin 5IU)

Utocin Injection is a medication containing Oxytocin at a strength of 5 International Units (IU) per ampoule. It’s manufactured by Umedica and is available in Nepal.

What is Utocin Used For?

Utocin Injection is primarily used to:

• Prevent or treat postpartum hemorrhage (excessive bleeding after childbirth).
• Induce labor when medically necessary.
• Manage abortion.
• Facilitate lactation (milk let-down).

Dosage Information

Adult Dosing:

• Postpartum Hemorrhage: Typically, 10-40 units (not exceeding 40 units) are added to 1000 mL of a non-hydrating IV solution and infused at a rate necessary to control uterine bleeding.
• Labor Induction: The usual starting dose is 0.5-1 mUnit/minute intravenously (IV), titrated up by 1-2 mUnit/minute every 15-60 minutes until a contraction pattern similar to normal labor is achieved (usually around 6 mUnits/minute). The dose may be decreased once the desired contraction frequency is reached and labor has progressed to 5-6 cm dilation.
• Incomplete or Inevitable Abortion: An IV infusion of 10-20 mUnit/minute is typically used, not to exceed 30 units over 12 hours.

Child Dose: No specific information provided.

Renal Dose: No specific information provided.

Administration

Utocin Injection is primarily administered intravenously (IV). Intramuscular (IM) administration is not commonly used due to unpredictable effects.

Important Considerations Before Using Utocin

Do NOT use Utocin if you have any of the following:

• Cephalopelvic disproportion (baby’s head is too large to fit through the mother’s pelvis).
• Abnormal presentation of the fetus.
• Hydramnios (excessive amniotic fluid).
• Multiparae (women who have had multiple previous pregnancies).
• Previous cesarean section or other uterine surgery.
• Hyperactive or hypertonic uterus (uterus is contracting too strongly or too frequently).
• Uterine rupture.
• Contraindicated vaginal delivery due to conditions like:
  • Invasive cervical cancer
  • Active genital herpes
  • Prolapse of the umbilical cord
  • Cord presentation
  • Total placenta previa or vasa previa
• Fetal distress where immediate delivery is not possible.
• Severe pre-eclamptic toxemia.

Use with Caution and Monitor Closely if you have:

• Cardiovascular disorders.
• Are over 35 years of age.
• Are lactating.

During treatment, it’s crucial to monitor:

• Fetal and maternal heart rate.
• Maternal blood pressure.
• Uterine motility (contractions).
• Fluid intake and output to prevent water intoxication.

Stop the infusion immediately if the uterus becomes hypertonic or hyperactive, or if there is fetal distress.

Note: Nasal spray forms of oxytocin may lead to maternal dependence. Prolonged use is not recommended for resistant uterine inertia, severe pre-eclampsia, or severe cardiovascular disorders. High doses over prolonged periods carry a risk of water intoxication.

Pregnancy and Lactation

• Oxytocin may be distributed into breast milk.
• It’s advisable to delay the commencement of nursing for at least one day after discontinuing oxytocin.
• Use with caution during lactation.

Drug Interactions

Tell your doctor about all medications you are taking, especially:

• Vasoconstrictors with caudal block anesthesia: Administering Utocin within 3-4 hours of a vasoconstrictor in this context can lead to severe hypertension.
• Cyclopropane anesthesia: May increase the risk of hypotension and maternal sinus bradycardia with abnormal AV rhythms.
• Dinoprostone and Misoprostol (vaginal prostaglandins): These can increase the uterotonic effect of oxytocin. Therefore, oxytocin should not be used within 6 hours after administering vaginal prostaglandins.
• Sympathomimetics: Concurrent use may increase their vasopressor effect.

Potentially Fatal Interactions:

• Concomitant use with prostaglandins significantly increases the risk of uterine rupture and cervical lacerations.

Possible Side Effects

For the Fetus or Neonate:

• Jaundice
• Arrhythmias, bradycardia (slow heart rate)
• Brain and central nervous system damage
• Seizures
• Retinal hemorrhage
• Low Apgar score

For the Mother:

• Transient hypotension (temporary low blood pressure)
• Reflex tachycardia (fast heart rate)
• Nasal irritation, rhinorrhea (runny nose), lacrimation (tearing) – specifically with nasal administration.
• Uterine bleeding, violent contractions, hypertonicity, spasm.
• Nausea, vomiting.

Potentially Fatal Side Effects:

• Maternal water intoxication (especially with slow infusion over 24 hours).
• Prolonged uterine contractions leading to fetal hypoxia and death.
• Rupture of the gravid uterus.
• Afibrinogenemia (lack of fibrinogen, a clotting factor).
• Subarachnoid hemorrhage (bleeding in the brain).

How Does Utocin Work?

Oxytocin, the active ingredient in Utocin, acts as a uterine stimulant, and also has vasopressive (constricts blood vessels) and antidiuretic (reduces urine production) effects. It works by activating G-protein-coupled receptors in the uterine muscle cells, which increases intracellular calcium levels. This leads to uterine contractions. It also boosts local prostaglandin production, further stimulating contractions.

d on the provided data and is not intended for diagnosis, medical advice, or treatment. It should not be used as a substitute for professional medical judgment. Always consult with a healthcare professional for any health concerns or before making any decisions related to your health or treatment.