Oxytocin

Oxytocin is a uterotonic hormone medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Induction of labour when there is a clear medical indication and vaginal delivery is appropriate.
• Augmentation of labour when uterine contractions are inadequate, under close maternal and fetal monitoring.
• Prevention and treatment of postpartum haemorrhage caused by uterine atony.
• Assisting uterine contraction after delivery of the placenta or after certain obstetric procedures, as directed by a specialist.
• Adjunctive management of incomplete or inevitable abortion in selected cases, according to clinical protocols.

Oxytocin injection is given by trained healthcare professionals, usually as a carefully controlled intravenous infusion for labour induction or augmentation, or by intramuscular or intravenous use for postpartum bleeding according to hospital protocol. The dose and rate must be individualized based on the indication, uterine response, maternal condition, and fetal monitoring. Do not self-administer; follow the prescribing doctor’s instructions exactly.

• Nausea, vomiting, abdominal cramping, or headache.
• Uterine hyperstimulation, prolonged or very strong contractions, uterine tetany, or uterine rupture.
• Fetal distress, abnormal fetal heart rate, low oxygen, or rarely fetal/neonatal complications related to excessive contractions.
• Low blood pressure, fast heartbeat, flushing, chest discomfort, or irregular heartbeat, especially with rapid intravenous administration.
• High blood pressure may occur, particularly with some interacting medicines.
• Water intoxication and low blood sodium, which can cause confusion, seizures, coma, or severe headache, especially with prolonged high-dose infusion and large volumes of fluid.
• Allergic reactions, including rare severe anaphylaxis.

Use extra caution in people with previous uterine surgery or caesarean section, multiple pregnancy, grand multiparity, overdistended uterus, hypertension or pre-eclampsia, heart disease, kidney problems, or any situation where close monitoring is difficult. Maternal contractions, blood pressure, fluid balance, and fetal heart rate should be monitored when used for labour. Use under a registered doctor's or pharmacist's guidance.

• Prostaglandins and other uterotonic medicines can greatly increase uterine contractions; timing and monitoring must be carefully managed.
• Ergot alkaloids or other postpartum uterotonics may increase the risk of high blood pressure or excessive uterine activity.
• Vasoconstrictors or sympathomimetics used with regional anaesthesia may increase the risk of severe hypertension.
• Inhalational anaesthetics may reduce the uterine effect of Oxytocin and increase the risk of low blood pressure or abnormal heart rhythm.
• Large volumes of electrolyte-free intravenous fluids can increase the risk of water intoxication and hyponatraemia.
• Medicines that prolong the QT interval may add to the rare risk of heart-rhythm problems; clinical judgment is needed.

• Known hypersensitivity to Oxytocin or any component of the injection.
• Any condition in which vaginal delivery is contraindicated, such as placenta previa, vasa previa, cord presentation or prolapse, or certain severe fetal malpresentations.
• Significant cephalopelvic disproportion or mechanical obstruction to delivery.
• Fetal distress when immediate vaginal delivery is not expected.
• Hypertonic uterine contractions or uterine hyperstimulation.
• High risk of uterine rupture, such as some types of previous major uterine surgery, unless a specialist determines that use is appropriate with full monitoring.

Oxytocin is specifically used during pregnancy and childbirth only when medically indicated and when appropriate monitoring is available. It should not be used for elective or unsupervised induction of labour. Small amounts may pass into breast milk, but it is generally considered compatible with breastfeeding when used appropriately after delivery; breastfeeding advice should follow the mother’s clinical condition and the doctor’s recommendation.

Store the injection as directed on the product label, commonly in a refrigerator at 2°C to 8°C and protected from light; do not freeze. Keep out of reach of children, and do not use if the solution is discoloured, contains particles, the ampoule/vial is damaged, or the expiry date has passed.