Is it possible to take oxytocin orally. Oxytocin-Gedeon Richter - official * instructions for use. Possible side effects in the mother

In the human body, the connection between the nervous and endocrine systems is carried out by the hypothalamus. This department is central nervous system synthesizes, among other things, a special hormone - the neurotransmitter oxytocin. This active substance comes from the cells of the hypothalamus to the pituitary gland. There it is stored and released into the bloodstream under the influence of external and internal stimuli.

Oxytocin affects the female reproductive system, the state of muscle tissue, the vascular wall and the emotional sphere of the personality.

This hormone has a fairly simple structure. Its chemical structure is a short chain of amino acids.

Many factors affect its production and release into the blood.

Increase the level of the substance:

• stimulation of the areola of the mammary gland;
• sexual contact;
• orgasm;
• massage;
• touching the body of another person;
• chronic pain;
• physical exercises;
• latching a baby to the breast (in nursing women);
• childbirth.

The concentration of oxytocin in the blood is higher at night. The circadian rhythm is especially well traced in pregnant women.

There are factors that lead to a drop in hormone levels. First of all, the secretion is suppressed by ethyl alcohol. In addition, loneliness, lack of mutual love and friendship, depression can lead to a drop in the concentration of this substance in the blood.

Generic activity

The hormone oxytocin has many effects on the human body. Its most studied function is associated with childbirth and lactation. In the last months of pregnancy, it is oxytocin that affects the tone of the muscles of the uterus (myometrium). The hormone stimulates fiber contraction. As a result, "training" preliminary contractions are formed first. Then, normally, in the period from 38 to 42 weeks, productive labor begins. Both preliminary contractions and childbirth itself are usually associated with night time. It is during this period of the day that the level of oxytocin is highest.

If the hormone is small or the myometrium is not sufficiently susceptible to this stimulus, then a true prolongation of pregnancy and weakness of labor are likely. It is known that oxytocin receptors can be blocked by some drugs. For example, hexoprenaline sulfate (ginipral) reduces the sensitivity of the uterus for up to a month.

In the postpartum period, the role of oxytocin is also high. The hormone helps to restore the normal volume of the uterus. The contraction of the muscle wall prevents bleeding and inflammation.

To stimulate weak labor, to induce labor and in the postpartum period, the synthetic hormone oxytocin is used. This drug is still considered the most popular remedy for uterine contractions.

Effects on lactation

Human milk is produced by prolactin. The more this substance, the more active and longer lactation. But the secretion of colostrum and milk from the areola is regulated by oxytocin. The hormone is reflexively released into the bloodstream when the baby is applied to the breast. Oxytocin reaches the mammary glands and promotes hot flashes and milk flow. If the reflex is impaired, then even with a large volume of prolactin, natural feeding is difficult.

Mother's love

A strong emotional bond between mother and baby is formed in the first weeks after birth. It is believed that oxytocin contributes to the development of this instinct. Mothers who breastfeed have more empathy for the baby. They better understand the feelings and needs of the child, anticipate his desires.

Of course, even with artificial feeding the emotional connection with the baby can be just as high. At the hormonal level, the emergence of maternal love is facilitated by touching, kissing and hugging a baby.

Love and sexual health

Oxytocin is closely related to intercourse and orgasm. This hormone helps to increase libido and strengthen sexual health in men. In women, it enhances the physical sensations during intercourse.

The hormone does more than just enhance sexual desires and abilities. It acts on the formation of attachment to one object of love. The higher the oxytocin level, the less the partner is prone to cheating and casual relationships.

In general, the concentration of the hormone affects the formation of close emotional attachment and love to a particular person. Satisfaction increases under its influence. sex life in a long-term relationship. Oxytocin affects the love between spouses, helps them go through all the crises of marriage together.

Impact on the psyche

A close relationship between autism and the concentration of oxytocin in the blood at the genetic level has been revealed. Research is currently underway to support the hormone's ability to improve emotional responses and recognition of loved ones. It is likely that in the future, drugs with this substance will be used to treat autism.

In addition, the hormone affects relationships with familiar people. High level oxytocin promotes manifestations of generosity, trust, friendship, and love.

The hormone has a negative effect on the processes of memorization and learning. Perhaps this property is necessary for women to overcome bad memories of the moment of childbirth.

Other effects

The hormone affects muscle fibers. The aging process of the muscles is replaced by natural rejuvenation after an increase in the concentration of oxytocin in the blood. In general, this substance promotes active longevity.

The hormone affects vascular tone. Oxytocin acts in opposition to vasopressin.

In addition, oxytocin can be seen as a natural barrier to increasing stress hormones (cortisol and adrenocorticotropin).

(2 estimates, average: 5,00 out of 5)

Oxytocin is a structurally complex hormone that is formed in the brain and performs functions in the body associated with childbirth and lactation. From the brain with the blood flow, oxytocin enters the target organs - the uterus and mammary glands, exerting its influence on them. Oxytocin has a stimulating effect on the smooth muscles of the uterus, increasing its contractile activity, and also affects lactation, since, firstly, it slightly increases the secretion of prolactin, a hormone responsible for milk production, and secondly, it contributes to the reduction of myoepithelial cells (cells surrounding the alveoli of the mammary gland in which milk is produced). This forces the milk out of the glands and into the ducts. Research recent years showed that oxytocin also has an effect on the psychoemotional sphere of men and women, causing a more benevolent disposition towards other people and increasing trust in strangers, and most importantly, oxytocin is involved in the formation of a mother's attachment to a child immediately after childbirth.

The concentration of oxytocin in the blood does not change in different phases and changes little during pregnancy, remaining at a low level. By the end of pregnancy, the amount of oxytocin increases and becomes maximum at night, and decreases during the day, which is why childbirth most often begins at night. During labor, the concentration of oxytocin rises even more and reaches a maximum by the end of the second and third stages of labor.

When and how is oxytocin used?

Oxytocin is administered only intramuscularly or intravenously, less often subcutaneously, since when taken orally, it is rapidly inactivated by enzymes in gastrointestinal tract... After intravenous administration of oxytocin, the uterokinetic effect, i.e. the action associated with an increase in the contractile activity of the uterus appears after 3-5 minutes and lasts about 3 hours. When oxytocin is administered to pregnant women, insignificant amounts of it reach the fetus, and it does not have any significant effect on the fetus. In a woman's body, oxytocin is rapidly destroyed by the enzyme of the same name - oxytocinase, which is located in the muscle of the uterus, mammary glands and placenta. The activity of oxytocinase during pregnancy increases 10 times, which allows you to regulate the concentration of oxytocin in the muscle of the uterus. It is assumed that the sensitivity of the uterus to oxytocin also depends on the number of specific oxytocin-sensitive receptors of the myometrium, which increases during pregnancy, reaching a maximum at the onset of labor.

Based on the action of synthetic oxytocin, indications for its use have been developed. Most obstetricians are quite rightly of the opinion that oxytocin should be prescribed only with therapeutic purpose, and for the rapid completion of a normally proceeding pregnancy, when drug treatment is not required, and stimulation performed at the request of the pregnant woman is categorically not acceptable. Therefore, the indications for the appointment of oxytocin are currently well defined.

Oxytocin is prescribed, firstly, to initiate (induce) and stimulate labor for medical reasons, i.e. in situations where rapid delivery through the vaginal birth canal is necessary due to the high risk of complications in the mother and fetus. This can happen, for example, with premature rupture of amniotic fluid and the absence of contractions, since in this situation, a long (12 hours or more) anhydrous interval increases the risk of infection of the uterus and fetal membranes. Rapid delivery is mandatory in severe progressive gestosis of pregnancy (a condition that is more often manifested by the appearance of edema, protein in the urine, increased blood pressure) - with this complication of pregnancy, the condition of both the mother and the fetus suffers. The indication for the administration of oxytocin is also pronounced (while the mother's body produces antibodies that destroy the red blood cells of the fetus). It is pregnancy that is the determining factor in the development of these conditions; they can be effectively treated only after delivery. In these situations, oxytocin is used only if the cervix is ​​already ready for childbirth - softened, shortened, its canal is slightly open. If the cervix is ​​not yet ready, use different methods, aimed at accelerating the ripening of the neck.

Secondly, oxytocin is used to stimulate or re-intensify labor in the event of a weakening or termination of uterine contractile activity, i.e. with weakness of labor. Weakness of labor is a condition in which the intensity, duration and frequency of contractions are insufficient, therefore, the smoothing of the cervix, the opening of the cervical canal and the advancement of the fetus occur at a slower pace. Primary weakness of labor activity develops from the very beginning of labor, and secondary - after a period of long good labor activity. Weakness of labor is diagnosed by the slow dynamics of the opening of the uterine pharynx (less than 1-1.2 cm per hour) and by the lack of fetal advancement through the birth canal when the size of the pelvis of the mother and the fetus matches. Prolonged immobility of the fetus in the pelvic cavity can lead to compression of the mother's soft tissues with the subsequent occurrence of urogenital or genital fistulas in her and to adverse effects on the fetal head up to cerebrovascular accident and cerebral hemorrhage. Timely administration of oxytocin with weakness of labor helps to avoid such complications.

A bit of history
Oxytocin is the first artificially synthesized hormone. In 1953, the American chemist Vincent Du Vigno studied the structure of oxytocin, and a year later he synthesized it in vitro, i.e. v artificial conditions outside a living organism, for which in 1955 he received Nobel Prize in chemistry. Currently, only synthetic oxytocin is used, and previously, oxytocin obtained from animals was used.

In the postpartum period, oxytocin is prescribed mainly to contract the uterus in order to prevent postpartum (hypotonic) uterine bleeding. For the same purpose, during a cesarean section, the drug is injected into the muscle of the uterus.

In addition, after childbirth, oxytocin is used for the prevention and treatment of lactostasis, since it facilitates the initial evacuation of milk from the mammary glands in the early postpartum period, provided that milk formation occurs normally.

Caution Needed!

But for whatever indications oxytocin is prescribed, its use is permissible only with adequate medical supervision, and the use of oxytocin as an initiator or stimulant of labor can be carried out only in a hospital. In this case, oxytocin is administered in such a way that the rate of cervical opening does not differ from those observed during normal childbirth, since both for the mother and the fetus, excessive stimulation of uterine contractions is extremely dangerous.

When prescribing oxytocin, contraindications to rhodostimulation are always taken into account. Oxytocin is contraindicated:

• with a discrepancy between the sizes of the pelvis and the fetal head, as well as with an incorrect position of the fetus, when delivery through the natural birth canal is impossible - for example, with a large fetus, with (pathology of the fetal brain), with the transverse position of the fetus, with a narrow pelvis, frontal presentation - when the head of the fetus is located in such a way that it cannot pass through the birth canal; when the umbilical cord is present (when the umbilical cord is near the exit from the cervix) or when it prolapses, since in this case, birth through the natural birth canal can lead to the death of the fetus, as well as when, because this situation threatens the development of bleeding and is an indication for a cesarean section;
• with a threatening rupture of the uterus, tk. At the same time, birth stimulation can contribute to the rupture of the uterus, which is dangerous for the life of the mother and for the life of the fetus;
• in the presence of scars on the uterus, including scars after cesarean section and myomectomy (surgery to remove nodes of a benign uterine tumor -), because inconsistency of the scars is possible, and therefore the threat of rupture of the uterus;
• in the presence of obstacles to delivery through the vaginal birth canal, for example, with a tumor of the cervix, atresia (infection of the cervix) and its cicatricial changes that prevent the opening of the cervix;
• in the presence of data on increased sensitivity to oxytocin in this patient (there is evidence of oxytocin hyperstimulation of the uterus in previous labor);
• with an immature cervix.

With extreme caution, they decide on the appointment of oxytocin for multiple pregnancies and uterine fibroids.

Oxytocin is used with extreme caution even if the fetus has signs of hypoxia - insufficient oxygen supply, since when oxytocin is used, contractions become more frequent and longer, and during contractions, the blood supply to the placenta significantly deteriorates.

To prevent complications from the use of oxytocin, the dosage of the drug and the mode of administration are strictly observed. The dose of oxytocin administered depends on the indication for its appointment. A large dose is usually required to initiate labor, and a smaller dose to intensify labor. The rate of administration of the drug is gradually increased from a few drops to tens of drops per minute until vigorous labor is established. With the development of sufficient labor, the rate of administration of the oxytocin solution is reduced to the minimum maintenance dose. Preference is given to methods of administration using perfusion pumps, the so-called infusion pumps - special devices allowing accurate dosing medications and maintain a constant target drug delivery rate.

During the entire period of administration of oxytocin to control labor and the state of the fetus, obstetricians determine the strength of uterine contractions and the frequency of fetal heart contractions. For this, as a rule, continuous monitoring is carried out using CTG (cardiotocography). The cardiotocograph simultaneously records on paper the frequency and amplitude of contractions and how they affect the fetal heart rate. When the condition of the fetus deteriorates, which is diagnosed by a change in its heartbeat, and in the absence of conditions for rapid delivery through the vaginal birth canal, as well as if the delivery is ineffective, a cesarean section is performed.

Marina Ershova
Obstetrician-gynecologist, Moscow

If someone reads this.

After giving birth, my wife has a dilated uterus, a week has passed and the doctor (in the female consl) wrote us to inject oxytocin intramyrx 2 times.

We will get rid of it, it can somehow affect the child, since he is drinking milk from the breast of the mother.

08/27/2008 01:55:01 AM, vladimir

Oxytocin, prostaglandins and antiprogestogens are drugs that obstetricians use to artificially induce labor and stimulate contractions, to "ripen" the cervix, all of these drugs primarily cause a violation of the uteroplacental circulation, which reduces blood flow through the umbilical cord to the baby, and these drugs they act like this all the time they are in the woman's body. Moreover, the doses administered to each woman in labor act individually, that is, the strength of the action of these drugs cannot be foreseen in advance. And the child strains all his strength to compensate for the decrease in the supply of oxygen with his mother's blood, since the flow of maternal blood is reduced because of the "drugs" administered by the obstetricians (oxytocin, etc.) Now imagine that the child does not have enough strength to fight and the child's self-regulation of blood circulation will be impaired. The brain immediately begins to suffer - its cells do not live long without oxygen. What do obstetricians think, when they say to women in labor, your child suffers, he has hypoxia and therefore we immediately inject oxytocin (or prostaglandin) in order to save the child from hypoxia. "Pretty salvation" after which the born child will necessarily have disturbances in the development of the central nervous system. Lucky - ADHD, cerebral palsy, episodic syndrome, autism syndrome, blindness, deafness, and so on. Who will stop the artificial intervention of obstetricians in childbirth with oxytocin and other "drugs" that are really dangerous for the health of newborn babies, the preservation and normal development of their brain?

08.02.2008 18:05:45, doktor

and the doctor does not know that with severe gestosis and including high pressure oxytocin can not be used?

12/20/2007 22:41:28, ekaterina

It would be nice if all the indications for use were vouched, otherwise the neonatologist from the hospital says "oxytocin flows like a river, to the questions of women in labor, what they are injected, the answer is riboxin, and there is oxytocin, as if the goal is to empty the uterus, and what about the baby ... "

"causing a more sympathetic disposition towards other people and increasing trust in strangers" -100 points! :))))

Oxytocin is a hypothalamic hormone. Here the hormone is produced and along the axons of the neurons of the hypothalamo-pituitary tract enters the posterior lobe of the pituitary gland, which acts as a reservoir.

Composition and form of release

Release form

The drug is available in ampoules in the form of a clear solution, which, according to the instructions, is recommended to be administered intramuscularly or intravenously. 1 ml of a solution containing 5 IU of oxytocin.

5 or 10 ampoules with instructions for use, an ampoule scarifier are placed in a carton box with a corrugated liner.

Solution composition

• Active substance: 1 ml of solution contains 5 IU;
• Excipients: chlorobutanol hemihydrate, water for injection.

pharmachologic effect

The hormone has a protein nature, has a stimulating effect on the contractions of the muscles of the uterus in late pregnancy, as well as throughout the labor process until delivery. In general, it regulates behavioral responses that are associated with pregnancy and labor.

Oxytocin has a stimulating effect on the smooth muscles of the uterus. Taking medication helps to increase contractile activity reproductive organ and the tone of the myometrium (the muscle layer of the uterus), helps to contract the myoepithelial cells that surround the alveoli of the mammary glands, which ultimately promotes the movement of milk into the large ducts and milk sinus. In addition, the drug has weak vasopressin-like antidiuretic properties, it allows you to enhance the reabsorption of water by the kidneys - it reduces urination.

Currently, it is obtained synthetically, unlike a natural substance, it does not contain impurities of other hormones, therefore its effect on the myometrium is selective. Since Oxytocin is protein-free, it can be taken intravenously without fear of anaphylactic action. The mechanism of action is associated with the effect on the cells of the myometrium: the permeability of membranes for potassium ions increases and excitability increases. The frequency and duration of uterine contractions increases. Stimulates milk secretion by increasing the production of the hormone prolactin (lactogenic hormone) and increasing the contraction of cells in the lactating mammary gland. Taking the medication has a mild antidiuretic effect.

If the drug is injected in a stream and very quickly, then the relaxing effect on vascular smooth muscles is intense, which ultimately leads to a temporary decrease in blood pressure and the patient's pulse quickens.

Indications for the use of Oxytocin

• in women with premature pregnancy at 42 weeks or more;
• in late pregnancy, if delivery is urgently needed;
• with primary or secondary weakness during childbirth in the first and second stages of labor;
• with Rh-conflict;
• if the fetus is frozen inside the uterus;
• if the membranes of the fetus ruptured prematurely;
• with intrauterine growth retardation.

Also, the drug Oxytocin is often used to treat and prevent bleeding after an abortion or labor, which ended in a cesarean section. In addition, the solution is taken for incomplete or failed abortion.

Contraindications

• the presence of contraindications for vaginal delivery (narrow pelvis, partial or complete placenta previa, prolapse or previa of the umbilical cord);
• oblique or lateral position of the fetus, which prevents the exit of the fetus;
• emergency situations when surgery is required;
• hypertonicity of the uterus that occurred during labor;
• a state of distress long before the terminal stages of pregnancy;
• severe gestosis, when kidney function is impaired or blood pressure is above normal;
• long-term use with inertia of the uterus;
• facial presentation of the fetus in the womb;
• malfunctioning of the kidneys;
• squeezing the fetus;
• pathologies of the heart;
• excessive stretching of the uterus;
• special sensitivity to the drug.

Side effects

On the part of the heart and blood vessels: if oxytocin is administered too quickly, subarachnoid hemorrhage and bradycardia may occur. Also, the rapid introduction of the drug can lead to the fact that the patient's blood pressure may rise or, on the contrary, it may decrease, and reflex tachycardia may begin.

Reproductive system: tetany, spasm, uterine hypertension, uterine rupture.

Digestive system: dyspeptic symptoms.

The immune system: allergy, anaphylaxis.

Water-electrolyte exchange: with prolonged intravenous administration, severe overhydration is possible, sometimes accompanied by convulsions and coma.

But, besides the fact that the use of the drug brand Oxytocin can cause serious consequences not only in the woman's body, but also in her unborn child.

Instructions for use

Method and dosage

The instructions note that for drip injection into a vein, you need to dilute 1 ml of the drug in 500 ml of 5% glucose and drip 10 drops per minute. To stimulate labor, it is recommended to inject Oxytocin 1 U every half an hour or an hour, depending on how the uterus reacts, but as practice has shown, the drug gives the best results if it is administered intravenously drip at 8-30 drops per minute, 1- 5 IU diluted in 5% glucose (300-500 ml) until the end of labor and separation of the placenta.

Oxytocin for the treatment of diseases

To stimulate labor in women with weak contractions and prolonged labor, the drug should be administered intramuscularly at 0.5-1 U every hour. During childbirth, when the fetus has a breech presentation, 2–5 U of the drug is administered. In case of hypotension and atony of the uterus, the use of 5-10 IU of Oxytocin is prescribed, intravenously, in 10-20 ml of a 40% glucose solution. To stimulate lactation, the drug is administered intramuscularly or into the nose (using a pipette) at 0.5 U 5 minutes before feeding; repeat the injection if necessary.

With premenstrual syndrome - in the nose, from the 20th day of the cycle to the 1st day of menstruation. For the prevention and treatment of hypotonic uterine bleeding in the postpartum period, the drug is administered intramuscularly at a dose of 3-5 IU. In some cases (after a cesarean section, overstretching of the uterus during prolonged labor with weak labor), it is possible to inject the drug into the cervix or the wall of the uterus (after birth or removal of the placenta) at a dose of 3-5 IU. Before injecting the drug into the body, all syringes must be pre-rinsed with water for injection.

Oxytocin for children

According to the instructions in childhood it is strictly forbidden to use Oxytocin.

During pregnancy and lactation

There are no known indications for use in the first trimester of pregnancy, except in connection with spontaneous or artificial termination of pregnancy. Wide experience the use of the drug, its chemical structure and pharmacological properties indicate that when using this medicinal product according to indications, it does not lead to the formation of fetal malformations.

In small amounts, Oxytocin passes into breast milk. In cases of using the drug to stop uterine bleeding, breastfeeding is possible only after the end of the course of drug treatment.

special instructions

As for how much the drug should be taken in each individual case, the doctor should select for each woman, depending on her condition. This drug must be prescribed by a doctor and administered under his close supervision in a hospital setting. The doctor should monitor the condition of the fetus, the level of blood pressure and the general condition of the woman.

Interaction with other drugs

Oxytocin tends to enhance the pressor effect of sympathomimetic amines. If it is prescribed in conjunction with the intake of MAO inhibitors, then the risk of an increase in blood pressure significantly increases. Halothane and cyclopropane, when combined with Oxytocin, increase the risk of arterial hypotension.

Domestic and foreign analogues

• Prepidil is an analogue of Oxytocin, which is recommended for women to stimulate the maturation of the cervix with a premature pregnancy, or to induce labor.
• Enzaprost-F - this drug is recommended to be used for abortion from 16 to 20 weeks or for induction of labor, for expelling the contents of the uterus if the fetus is frozen in the womb.
• Desaminooxytocin - this analogue is intended to stimulate labor, subinvolution of the uterus and to stimulate lactation after the birth of a baby.

Price in pharmacies

The price of Oxytocin in different pharmacies can vary significantly. This is due to the use of cheaper components and the pricing policy of the pharmacy chain.

Check out official information about the drug Oxytocin, the instructions for use of which include general information and a treatment regimen. The text is provided for informational purposes only and cannot serve as a substitute for a doctor's advice.

P N013027 / 01

Trade name of the drug: OXYTOCIN

International Non-Proprietary Name (INN): oxytocin

Chemical name: oxytocin

Dosage form:

solution for intramuscular and intravenous administration.

Composition:

The active ingredient is oxytocin 5 IU in each ampoule. Excipients - glacial acetic acid 2.50 mg; chlorobutanol hemihydrate 3.00 mg; ethanol (96%) 40.00 mg; water for injection to obtain 1.00 ml of solution in each ampoule.

Description:
Colorless, transparent solution, practically free from mechanical impurities.

Pharmacological properties

Pharmacotherapeutic group:

Labor activity stimulant-drug oxytocin.
ATX code:Н01В В02
Pharmacodynamics: A synthetic hormonal agent, pharmacological and clinical properties are similar to endogenous oxytocin of the posterior lobe of the pituitary gland.
Interacts with oxytocin-specific receptors of the uterine myometrium, which belong to the superfamily of G-proteins. The number of receptors and the response to the action of oxytocin increase as pregnancy progresses and reach a maximum towards the end of it. Stimulates the labor activity of the uterus by increasing the permeability of cell membranes for Ca + and an increase in the intracellular concentration of the ion, a subsequent decrease in the resting potential of the membrane and an increase in its excitability. Causes contractions similar to normal spontaneous labor, temporarily impairing the blood supply to the uterus. With an increase in the amplitude and duration of muscle contractions, the expansion and smoothing of the uterine pharynx occurs. In appropriate quantities, it is able to enhance the contractility of the uterus from moderate in strength and frequency, characteristic of spontaneous motor activity, to the level of prolonged tetanic contractions.
It causes a reduction in myoepithelial cells adjacent to the alveoli of the breast, improving the secretion of breast milk.
By acting on vascular smooth muscle, it causes vasodilation and increases blood flow in the kidneys, coronary vessels and blood vessels brain... Usually, blood pressure remains unchanged, however, with intravenous administration of large doses or a concentrated solution of oxytocin, blood pressure may temporarily decrease with the development of reflex tachycardia and a reflex increase in cardiac output. An initial decrease in blood pressure is followed by a prolonged, albeit small, increase.
Unlike vasopressin, oxytocin has a minimal antidiuretic effect, however, overhydration is possible when oxytocin is administered with large amounts of electrolyte-free fluids and / or when they are administered too quickly. Does not cause contraction of the muscles of the bladder and intestines.
Pharmacokinetics: When administered intravenously, the effect of oxytocin on the uterus manifests itself almost instantly and lasts for 1 hour. When administered intramuscularly, the myotonic effect occurs in the first 3-7 minutes and lasts for 2-3 hours.
Like vasopressin, oxytocin is distributed throughout the extracellular space. Small amounts of oxytocin appear to enter the fetal circulation. The half-life is 1-6 minutes, it is shorter in late pregnancy and lactation. Most of the drug is rapidly metabolized in the liver and kidneys. In the process of enzymatic hydrolysis, it is inactivated, first of all, by the action of tissue oxytokinase (oxytokinase is also found in the placenta and plasma). Only a small amount of oxytocin is excreted unchanged in the urine.

Indications
Oxytocin is intended for labor induction and labor stimulation.
Labor arousal at late or close to them stages of pregnancy, if necessary premature delivery due to gestosis, resusconflict, early or premature rupture of the membranes of the fetus and the discharge of amniotic fluid, post-term pregnancy (more than 42 weeks), intrauterine fetal growth retardation, intrauterine fetal death.
Stimulation of labor activity: with primary or secondary weakness of labor in the first or second stages of labor.
Prevention and treatment of hypotonic bleeding after childbirth and abortion, with caesarean section (after the birth of the child and separation of the placenta), to accelerate postpartum involution.
Others: as adjunctive therapy for incomplete or inevitable abortion.

Contraindications
Hypersensitivity to oxytocin; the presence of contraindications for vaginal delivery (for example, umbilical presentation or prolapse of the umbilical cord, full or partial (vasa previa) placenta previa; narrow pelvis (discrepancy between the size of the fetal head and the woman's pelvis); transverse and oblique position of the fetus, preventing spontaneous delivery; emergency, requiring surgical intervention situations caused by the condition of the woman in labor or the fetus; states of fetal distress long before the terminal stages of pregnancy; long-term use with inertia of the uterus; severe gestosis (high blood pressure, impaired renal function); hypertonicity of the uterus (not arising during childbirth); uterine sepsis, heart disease, arterial hypertension, impaired renal function, fetal presentation, excessive stretching of the uterus, fetal compression.
Except in special circumstances, the drug is also contraindicated in the following situations: premature birth; history of volumetric surgery on the uterus or cervix (including cesarean section); hypertonicity of the uterus; multiple pregnancy; invasive stage of cervical carcinoma.

Pregnancy and lactation
In the first trimester of pregnancy, oxytocin is used only for spontaneous or induced abortion. Numerous data on the use of oxytocin, its chemical structure and pharmacological properties indicate that, subject to the instructions for use, oxytocin does not affect the formation of fetal malformations.
In small quantities passes into breast milk.
When using the drug to stop uterine bleeding, breastfeeding can be started only after the end of the course of treatment with oxytocin.

Method of administration and dosage
Intravenous or intramuscular.
With a chain of induction and enhancement of labor, oxytocin is used exclusively intravenously, in a hospital setting, with appropriate medical supervision. The simultaneous use of the drug intravenously and intramuscularly is contraindicated. The dose is selected taking into account the individual sensitivity of the pregnant woman and the fetus.
For labor induction and stimulation of labor, oxytocin is used exclusively in the form of intravenous drip infusion. Strict control of the prescribed infusion rate is imperative. For the safe use of oxytocin during induction and intensification of labor, it is necessary to use an infusion pump or other similar device, as well as monitor the strength of uterine contractions and fetal cardiac activity. In the event of an excessive increase in the contractile activity of the uterus, the infusion should be stopped immediately, as a result, the excessive muscle activity of the uterus rapidly decreases.
1) Before starting the administration of the drug, you should begin to inject a saline solution that does not contain oxytocin.
2) To prepare a standard infusion of oxytocin in 1000 ml of non-hydrating liquid, dissolve 1 ml (5 IU) of oxytocin and mix thoroughly by rotating the bottle. 1 ml of the infusion prepared in this way contains 5 IU of oxytocin. For accurate dosing of the infusion solution, an infusion pump or other similar device should be used.
3) The rate of administration of the initial dose should not exceed 0.5-4 milliunits per minute (IU / min) (corresponds to 2-16 drops / min, since 1 drip of infusion contains 0.25 IU of oxytocin). Every 20-40 minutes, it can be increased by 1-2 honey / min, until the desired degree of uterine contractile activity is achieved. Upon reaching the desired frequency of uterine contractions, corresponding to spontaneous labor, and the opening of the pharynx of the uterus to 4-6 cm in the absence of signs of fetal distress, you can gradually reduce the rate of infusion at a rate similar to its acceleration.
In late pregnancy, infusion at a higher rate requires caution, only in rare cases may a rate in excess of 8-9 IU / min be required. In the case of premature birth, a high speed may be required, which in isolated cases may exceed 20 IU / min (80 drops / min).
1) It is necessary to control the fetal heartbeat, the tone of the uterus at rest, the frequency, duration and strength of its contractions.
2) In case of uterine hyperactivity or fetal distress, the administration of oxytocin should be stopped immediately and the woman in labor should be given oxygen therapy. The condition of the woman in labor and the fetus must be re-monitored by a specialist doctor.
Prevention and treatment of hypotonic bleeding in the postpartum period:
1) Intravenous drip infusion: dissolve 10-40 IU of oxytocin in 1000 ml of non-hydrating liquid; for the prevention of uterine atony, 20-40 IU / min of oxytocin is usually needed.
2) Intramuscular administration: 5 IU / ml oxytocin after placenta separation.
Incomplete or failed abortion:
Add 10 IU / ml oxytocin to 500 ml of saline or a mixture of 5% dextrose with saline. Intravenous infusion rate 20-40 drops / min.

Side effect
In women in labor:
On the part of the reproductive system: at high doses or increased sensitivity - uterine hypertension, spasm, tetany, uterine rupture, increased bleeding in the postpartum period as a result of oxytocin-induced thrombocytopenia, afibrinogenemia and hypoprothrombinemia, sometimes hemorrhage in the pelvic organs. With close medical supervision of childbirth, the risk of bleeding in the postpartum period is reduced.
From the side of cardio-vascular system: at high doses - arrhythmia; ventricular premature beats; severe hypertension (in the case of the use of vasopressor drugs); hypotension (when used simultaneously with the anesthetic cyclopropane); reflex tachycardia; shock; if administered too quickly: bradycardia, subarachnoid bleeding.
From the digestive system: nausea, vomiting.
From the side of water-electrolyte metabolism: severe overhydration with prolonged intravenous administration (usually at 40-50 IU / min) with a large amount of fluid (antidiuretic effect of oxytocin), proceeding with convulsions and coma is possible with a 24-hour, slow infusion of oxytocin; rarely - death.
From the immune system: anaphylaxis and other allergic reactions, with too rapid administration of bronchospasm; rarely fatal
In a fetus or newborn:
As a result of the administration of oxytocin to the mother - within 5 minutes, a low score on the Apgar scale, jaundice of newborns, with too rapid administration - a decrease in fibrinogen in the blood of the fetus, hemorrhage in the retina; as a result of increased contractile activity of the uterus - sinus bradycardia, tachycardia, ventricular premature beats and other arrhythmias, residual changes in the central nervous system, fetal death as a result of asphyxia.

Overdose
Symptoms depend mainly on the degree of uterine hyperactivity, regardless of the presence of hypersensitivity to the drug. Hyperstimulation with hypertonic and tetanic contractions or with a base tone of ≥15-20 mm aq. Art. between two contractions leads to promiscuous labor, rupture of the body or cervix, vagina, bleeding in the postpartum period, uteroplacental insufficiency, fetal bradycardia, hypoxia, hypercapnia, compression, birth trauma or death. Overhydration with convulsions as a result of the antidiuretic effect of oxytocin is a serious complication and develops with prolonged administration of large doses (40-50 ml / min).
Treatment of overhydration: cancellation of oxytocin, limitation of fluid intake, use of diuretics to force diuresis, intravenous administration of hypertensive saline solution, correction of electrolyte imbalance, relief of seizures with appropriate doses of barbiturates and provision of professional care for the patient in a coma.

Drug interactions
With the introduction of oxytocin 3-4 hours after the use of vasoconstrictors in conjunction with caudal anesthesia, severe arterial hypertension is possible.
Under anesthesia with cyclopropane, halothane, it is possible to change the cardiovascular action of oxytocin with the unforeseen development of arterial hypotension, sinus bradycardia and atrioventricular rhythm in a woman in labor during anesthesia.

special instructions
Before proceeding with the use of oxytocin, the expected beneficial effect of therapy should be compared with the possibility, albeit rare, of the development of hypertension and tetany of the uterus.
Until the moment of insertion of the fetal head into the pelvic entrance, oxytocin cannot be used to stimulate labor.
Each patient receiving intravenous oxytocin should be in the hospital under the constant supervision of experienced professionals who are familiar with the drug and recognized as qualified in recognizing complications. Immediate, if necessary, specialist medical assistance should be provided. During the use of the drug, the uterine contractions, the cardiac activity of the woman in labor and the fetus, the blood pressure of the woman in labor should be constantly monitored in order to avoid complications. If there are signs of uterine hyperactivity, the administration of oxytocin should be stopped immediately; as a result, drug-induced uterine contractions usually subside soon.
When used appropriately, oxytocin induces uterine contractions similar to spontaneous labor. Excessive stimulation of the uterus with improper use of the drug is dangerous for both the woman in labor and the fetus. Even with adequate use of the drug and appropriate supervision, hypertensive contractions of the uterus occur with increased sensitivity of the uterus to oxytocin.
The risk of developing afibrinogenemia and increased blood loss should be considered.
There are known cases of death of a woman in labor as a result of hypersensitivity reactions, subarachnoid hemorrhage, rupture of the uterus and fetal death for various reasons associated with parenteral administration of the drug for induction of labor and stimulation in the first and second stages of labor.
As a result of the antidiuretic effect of oxytocin, the development of overhydration is possible, especially with the use of a constant infusion of oxytocin and the use of liquid inside.
The drug can be diluted in solutions of sodium lactate, sodium chlorate and glucose. The prepared solution should be used in the first 8 hours after preparation. Compatibility studies were performed with 500 ml infusions.
The effect of the drug on the ability to drive a car and mechanisms, work on which is associated with an increased risk of injury: oxytocin does not affect the ability to drive a car and mechanisms, work on which is associated with an increased risk of injury.

Release form
1 ml solution for injection in a glass ampoule, 5 ampoules in cardboard box with instructions for medical use.

Shelf life
3 years.
Do not use the drug after the expiration date indicated on the package.

Storage conditions
Store at a temperature of 2-15 ° C, protected from light, out of the reach of children.

Conditions of dispensing from pharmacies
On prescription.

Manufacturer
Gedeon Richter A.O.
1103 Budapest, st. Dyemrei, 19-21, Hungary Moscow Representative Office: st. Krasnaya Presnya, 1-7.

Labor activity in women is regulated by the hormone oxytocin, a substance produced in the hypothalamus and accumulating in the posterior lobe of the pituitary gland. In gynecology, an artificially synthesized bioactive component has been used for a long time: it is used to stimulate labor and accelerate the recovery of a woman's body in the postpartum period.

What is Oxytocin

A synthetic hormonal preparation designed to stimulate labor. Oxytocin does not have any impurities in the form of other active proteinaceous substances. The tool, according to the instructions, has a directed effect on the muscles of the uterus. With intravenous infusion, the hormone does not carry the risk of developing anaphylactic shock. The influence of a biologically active substance is due to an increase in the permeability of the cell membranes of the uterus for potassium ions, thereby increasing the conductivity of nerve impulses.

The mechanism of action of the solution is aimed at strengthening the contractions of the uterus. After a baby is born, Oxytocin increases the production of prolactin, a hormone that enhances lactation. In addition, the biologically active substance has a mild antidiuretic effect on the woman's body, due to which the optimal amount of fluid is retained in the body of the woman in labor, the vessels are narrowed, which prevents bleeding.

Composition and form of release

The medicine Oxytocin is a solution for intravenous or intramuscular administration. The medication is a clear liquid without mechanical impurities, active substance in which the synthetic hormone oxytocin serves (5 IU in 1 ampoule). Auxiliary components are ethanol (96%), acetic acid, chlorobutanol hemihydrate, water for injection. The drug is produced in the following forms:

Pharmacodynamics and pharmacokinetics

Oxytocin, according to the instructions, has a stimulating effect on the smooth muscles of the uterus. Due to this, the contractile activity of the organ increases and the tone of the myometrium slightly increases, which is important with weak labor. In small quantities, the solution is able to increase the frequency and amplitude of uterine contractions. When a large dose is administered, the agent helps to increase the tone of the uterus, accelerates and intensifies its contractions, up to tetanic.

In addition, the hormone enhances the production of prolactin and the contraction of the myoepithelial cells that surround the alveoli of the breast. Thus, Oxytocin increases milk production. The drug has weak vasopressin-like antidiuretic properties, due to which it has a wide spectrum of action and is used everywhere. It stimulates uterine contractions, maintains the tone of the organ, which is especially important with weak contractions during childbirth. Even a small dose of Oxytocin can make the birth process easier.

In some cases, the drug is used for late abortion (injection causes premature birth). The action of Oxytocin begins within 1-2 minutes after its administration. The metabolism of the drug is carried out in the liver. During pregnancy, the enzyme oxytocinase appears in the plasma, which deactivates exogenous and endogenous oxytocin. In addition to plasma, the hormone is also found in target organs. A significant amount of the drug is excreted by the kidneys unchanged.

Indications for use

The use of Oxytocin during pregnancy is allowed only when necessary. Indications for the introduction of a synthetic hormone are:

• the need to stimulate labor;
• prevention of uterine bleeding after miscarriage or abortion;
• swelling, weight gain before menstruation;
• the need to accelerate the process of uterine contraction after childbirth or cesarean section (after the placenta leaves);
• insufficient patency of the ducts of the mammary gland during lactation.

A special medical indication for the administration of Oxytocin, according to the instructions, is artificial childbirth. They are carried out in the following cases:

• with late toxicosis;
• due to the death of the fetus;
• with an identified Rh-conflict;
• if the amniotic fluid departed prematurely;
• when the gestational age is exceeded.

Method of administration and dosage

Instructions for the use of Oxytocin involves the use of a solution for intramuscular or intravenous administration. The latter method of injection is used to enhance labor, exclusively in a hospital setting. It is forbidden to simultaneously inject the solution intramuscularly and intravenously. The dosage is prescribed by the doctor by the selection method, taking into account the individual tolerance of the drug by the woman and the fetus.

Oxytocin intramuscularly

A solution in a dosage of 1 ml is administered to a woman in labor after the release of the fetus. If during the postpartum period the uterus contracts poorly, the woman is prescribed injections. The reaction of each patient to Oxytocin is different, so the dosage is prescribed individually, it varies from 2 to 10 IU. Sometimes the medication is prescribed for pregnant or lactating women. In the first case, the fetal heart rate is constantly monitored. Oxytocin injections for lactating women, according to the instructions, stimulate the work of the mammary glands and normalize the movement of milk through the ducts.

Intravenous oxytocin

The instructions for the drug say that the bioactive substance enhances labor. For this purpose, the solution is injected exclusively into a vein and in a hospital setting. The use of the hormone requires the mandatory use of additional medical equipment. The dosage of the medication depends on the reaction of the woman in labor and the fetus to the medication:

• Stimulation of labor activity begins with the introduction of saline to the woman, after 1 ml of Oxytocin is diluted in 1000 ml of non-hydrating liquid and the drug is injected at 2-16 drops per minute.
• To achieve the desired contractile activity of the uterine walls, the intensity is increased by 4-8 drops every 20-40 minutes.
• If the uterus has opened to the required level, the rate of administration of the hormonal agent is reduced in the reverse order.
• With artificial childbirth, taking place at a later date, the rate of administration of the solution is 32–36 drops.
• Premature birth is an indication to increase the infusion rate to 80 drops per minute. In this case, the child's heartbeat, the tone of the myometrium during contractions and at rest is necessarily monitored.
• When preventing uterine bleeding, 80–160 drops of solution are injected intravenously. In this case, 2–8 ml of Oxytocin is dissolved in a non-hydrating liquid (1000 ml).

Oxytocin for abortion

The action of the hormone is similar to the pharmacodynamics of natural oxytocin during childbirth. The drug causes excitement of the uterus and the opening of its cervix, due to which the birth of the fetus occurs. During an abortion, a woman is injected intravenously with a solution of 2 ml of the hormone and 500 ml of saline at a rate of 20–40 drops per minute. In some cases, the remedy is prescribed after the termination of pregnancy or the birth of a child. The hormone is necessary to eliminate the hypotonia of the uterus, its reduced contractile activity \ in order to avoid:

1. stagnant phenomena;
2. the development of bleeding;
3. endometritis (inflammation of the walls of the organ).

For animals

In veterinary medicine, the drug is used to stimulate labor in cattle and other animals. The drug, according to the instructions, causes contractions of the smooth muscles of the uterus, promotes the natural release of the placenta when it is retained. The introduction of the hormone, in addition, is indicated for atonic or uterine bleeding, reflex agalactia, uterine inflammation. Traditionally, in veterinary medicine, the drug is used to treat mastitis:

• in cows;
• pigs;
• cats, dogs;
• other types of animals.

According to the instructions, the agent is recommended to be administered intramuscularly, but intravenous or subcutaneous injections are also allowed. As prescribed by the veterinarian, the hormone is administered epidurally at the same time as novocaine. To accelerate the effect, you can inject the solution in combination with glucose. The appropriate dosage depends on the weight of the animal and can be calculated according to the instructions in the instructions.

special instructions

The introduction of Oxytocin, according to the instructions, begins after a careful comparison of the expected therapeutic effect with the possible risk of developing uterine hypertonia and tetany. Stimulation of labor is prohibited to begin before the appearance of the fetal head. Intravenous hormone injections should be carried out in a hospital under the constant supervision of experienced, qualified specialists. Close monitoring of delivery during Oxytocin administration reduces the risk of bleeding open after delivery.

To prevent the development of complications, the period of use of the drug is accompanied by monitoring of the cardiac activity of the fetus and mother, in addition, the blood pressure of the woman in labor and the dynamics of uterine contractions are monitored. The use of the solution according to the instructions should stimulate the work of the muscles of the uterus, similar to spontaneous childbirth. Recommendations and instructions:

• Improper use of the drug is dangerous due to excessive organ contractions and the development of hypersensitivity to the hormone, as indicated in the instructions.
• According to the instructions for the drug, when using it, it is important to take into account the risk of developing afibrinogenemia (absence of fibrinogen in the blood) and increased blood loss.
• The drug has antidiuretic properties, with constant administration and additional oral fluid intake, hyperhydration is possible.
• The product can be combined with sodium lactate, sodium chlorate and glucose solutions.
• The finished infusion should be used within 8 hours.
• The drug does not affect a person's ability to manage vehicle, complex mechanisms and does not impair its concentration.

Drug interactions

The therapeutic effect of a hormonal agent worsens when combined with inhalation anesthesia, antispasmodics and prostaglandins. When the drug is used together with vasoconstrictors 3-4 hours after epidural anesthesia or in combination with sympathomimetics, severe arterial hypertension may develop. The combination of the hormone with halothane or cyclopropane can cause a change in the cardiovascular action of Oxytocin and cause the development of the following in women in labor:

• arterial hypotension;
• arrhythmias;
• sinus bradycardia.

Side effects of Oxytocin

During drug therapy, some undesirable reactions are noted. With the symptoms described below, the use of the hormonal agent is canceled, while the administration of saline is reduced and an accelerated diuresis is performed. To normalize the electrolyte balance, hypertonic sodium chloride solution and barbiturates are administered... Against the background of drug treatment, even if all the requirements specified in the instructions are followed, women may experience the following side effects:

• hypertensive syndrome;
• decrease in blood pressure;
• bradycardia or arrhythmia (in the fetus and mother);
• vomiting, nausea;
• disorder of the digestive tract;
• subarachnoid (cerebral) bleeding;
• bronchospasm;
• water retention in the body;
• neonatal (intrauterine) jaundice;
• reduction in the level of fibrinogen in the fetus;
• allergy;
• hypoxia and asphyxia in a child.

Overdose

Oxytocin in ampoules (the name of the synthetic drug is pitocin) is extremely important to use according to the instructions in order to avoid extremely negative consequences caused by an overdose of a hormone in a woman's body. Signs of exceeding the permissible dose of the drug include:

• rupture of the uterus;
• hypoxia;
• tetanus of the uterus;
• water intoxication;
• postpartum bleeding;
• hypercapnia;
• uteroplacental hypoperfusion;
• birth trauma and fetal bradycardia;
• convulsions.

Contraindications

The use of the drug is prohibited in case of hypersensitivity to the active ingredient, preeclampsia (severe toxicosis that occurs in the 2nd or 3rd trimester of pregnancy). In addition, according to the instructions, the hormone is not used for:

• a narrow pelvis of a woman in labor;
• prolapse or presentation of the umbilical cord;
• placental abruption;
• oblique or transverse position of the fetus, which interferes with spontaneous childbirth;
• emergency situations requiring surgical intervention;
• excessive stretching of the uterus;
• uterine sepsis;
• facial presentation of the fetus, its compression;
• distress of the fetus long before the expected date of birth;
• severe gestosis (impaired renal function, high blood pressure);
• early hypertonicity of the uterus;
• arterial hypertension;
• heart disease;
• impaired renal function;
• hypersensitivity to hormonal agents;
• multiple pregnancy;
• premature birth;
• previously performed surgical intervention on the uterus and its cervix.