Solution, Injection: Pitocin: 10 units/mL (1 mL, 10 mL, 50 mL) [contains chlorobutanol (chlorobutol)] Generic: 10 units/mL (1 mL, 10 mL, 30 mL)
Maximum cumulative dose: 40 units (Sentilhes 2016).The dose may be administered using a standardized infusion containing 30 units in 500 mL NS or LR (AWHONN 2015; Sumikura 2016) or by adding 10 to 40 units to a running infusion solution depending on amount of infusion fluid remaining (maximum: 40 units in 1,000 mL of IV fluid); adjust infusion rate to sustain uterine contraction and control uterine atony.Lower bolus doses (0.5 to 3 units) for the prevention of postpartum bleeding have also been evaluated in women undergoing elective cesarean delivery (Butwick 2010; Carvalho 2004).Incomplete, inevitable, or elective abortion: 10 units as an IV infusion after suction or a sharp curettage (used to help contract the uterus)Induction or stimulation of labor: Add oxytocin 10 units to NS or LR 1,000 mL to yield a solution containing oxytocin 10 milliunits/mL or 30 units in 500 mL NS or LR (AWHONN 2015). Oxytocin may also be used for purposes not listed in this medication guide. Patients with additional risk factors for QTc prolongation may be at even higher risk.Cardiovascular: Cardiac arrhythmia, hypertensive crisis, hypotension (Dyer 2011), subarachnoid hemorrhage, tachycardia (Dyer 2011), ventricular premature contractionsEndocrine & metabolic: Water intoxication (severe water intoxication with seizure and coma is associated with a slow oxytocin infusion over 24 hours)Genitourinary: Postpartum hemorrhage, uterine ruptureElective induction of labor is defined as the initiation of labor in a pregnant individual who has no medical indications for induction. Specifically, oxytocic effects may be enhanced. We comply with the HONcode standard for trustworthy health information - Instruct client: It is also sometimes used to help milk secretion in breast-feeding. The risk of adverse events is influenced by dose and route of administration and is increased in women with cardiovascular disease. Administer oxytocin 30 minutes after removing dinoprostone vaginal insert and 6 to 12 hours after the application of dinoprostone gel.EPHEDrine (Nasal): Oxytocin may enhance the hypertensive effect of EPHEDrine (Nasal). Specifically, oxytocic effects may be enhanced. IV push is not recommended; rapid IV bolus administration is associated with cardiovascular collapse (ACOG 183 2017; Vallera 2017). Rotate solution to mix.Postpartum uterine bleeding: Add oxytocin 10 to 40 units to running IV infusion (maximum: 40 units to 1,000 mL) or 30 units in 500 mL NS or LR (AWHONN 2015; Sumikura 2016).Adjunctive management of abortion: Add oxytocin 10 units to 500 mL of a physiologic saline solution or D5W.Induction or stimulation of labor: Administer as an IV infusion (drip method) by use of an infusion pump; accurate control of the rate of infusion flow is essential.Incomplete or inevitable abortion: Administer by IV infusionPostpartum uterine bleeding: Administer by IV or IM. If used sequentially, monitor uterine activity closely. Oxytocin is a hormone that is used to induce labor or strengthen uterine contractions, or to control bleeding after childbirth. Higher infusion rates may be needed prior to term due to a lower sensitivity of the uterus.
Gemeprost: May enhance the adverse/toxic effect of Oxytocin.Haloperidol: QT-prolonging Agents (Indeterminate Risk - Caution) may enhance the QTc-prolonging effect of Haloperidol. Reduce the incremental increase to 3 milliunits/minute if hyperstimulation occurs; reduce the incremental increase to 1 milliunit/minute for recurrent hyperstimulation (ACOG 2009).5 units (Sentilhes 2016) or 10 units (AWHONN 2015; Sentilhes 2016; WHO 2012) may be given initially and can be followed by a maintenance infusion of 10 units/hour (AWHONN 2015; Sentilhes 2016).
This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Interventions and (Rationales) Client Education/Discharge Planning Instruct client about the purpose and importance of fetal monitoring.
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