[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Ergot alkaloids](https://durgical.com/en/pharmacology/classes/ergot-alkaloids/) › Ergometrine [Pharmacology](https://durgical.com/en/pharmacology/) · [Ergot alkaloids](https://durgical.com/en/pharmacology/classes/ergot-alkaloids/) # Ergometrine Ergot alkaloid on the WHO essential list that contracts the uterus to control bleeding after birth. Like methylergometrine, it is avoided in hypertension. Updated 2026-11-01 - Class: [Ergot alkaloids](https://durgical.com/en/pharmacology/classes/ergot-alkaloids/) - Receptor: Serotonin 5-HT2 and alpha-adrenergic receptors of the myometrium - ATC code: G02AB03 - WHO Model List of Essential Medicines Also called: Ergonovine ◎**Serotonin 5-HT2 and alpha-adrenergic receptors of the myometrium**Ergometrine ⓘ The figure shows methylergometrine, the methylated derivative of ergometrine, bound to the serotonin 5-HT2B receptor; ergometrine occupies the same kind of site. **Target in 3D:** Serotonin 5-HT2 and alpha-adrenergic receptors of the myometrium. PDB structure 6DRY (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6DRY) · Drag to rotate · pinch to zoom ## Mechanism of action Ergometrine is the parent compound of methylergometrine. It stimulates serotonin and alpha-adrenergic receptors of the uterus and produces a strong, sustained contraction that compresses the vessels of the placental bed. The same effect on blood vessels raises blood pressure. - It stimulates 5-HT2 and alpha-adrenergic receptors of the uterus - The uterus contracts strongly and stays contracted - Bleeding from the placental bed falls; vessels also constrict ## Pharmacokinetics **Absorption** Given IM or slowly IV **Metabolism** Liver, through CYP3A4, like the other ergot alkaloids ## Indications - Postpartum haemorrhage due to uterine atony, when hypertension has been excluded [Postpartum haemorrhage →](https://durgical.com/en/conditions/postpartum-haemorrhage/) ## Adverse effects ### Common - Nausea and vomiting - Headache - High blood pressure - Abdominal pain ### Serious (rare, important) - Hypertensive crisis, seizures and stroke - Coronary vasospasm and myocardial ischaemia - Severe ischaemia (ergotism) with strong CYP3A4 inhibitors ## Contraindications - Hypertension, pre-eclampsia and eclampsia - Heart disease, especially coronary artery disease - Pregnancy before birth - Use with strong CYP3A4 inhibitors ## Key interactions **Macrolides, HIV protease inhibitors, azole antifungals** CYP3A4 inhibition: higher levels and risk of severe vasospasm **Other vasoconstrictors** Additive vasoconstriction and hypertension **Oxytocin and prostaglandins** Additive uterotonic effect ## What is monitored - Blood pressure before and after the dose - Uterine tone and blood loss - Chest pain and signs of limb ischaemia ## Administration and safety - Check blood pressure first; it is not used in hypertension or pre-eclampsia. - IV injection is slow, with blood pressure checks. - Store as the label states (injectable ergot alkaloids are usually kept cold and protected from light) and away from newborn medicines. ## Nursing care - Before the dose: blood pressure and history of hypertension, pre-eclampsia or heart disease. - After the dose: blood pressure, uterine tone, lochia and pain. - Report chest pain, severe headache or cold, pale fingers. - Check the medicine list for CYP3A4 inhibitors. ## Pregnancy and breastfeeding Contraindicated before birth because it contracts the uterus; it is used after the birth to control bleeding. ## Memory aid Ergometrine is the «parent ergot»: same uterus, same pressure risk as methylergometrine. ## Test yourself Think of the answer, then tap the question to see it. ## What is the relation between ergometrine and methylergometrine? Methylergometrine is the methylated derivative of ergometrine; both are ergot alkaloids that contract the uterus and raise blood pressure. ## Which condition must be excluded before using ergometrine for bleeding after birth? High blood pressure, including pre-eclampsia. ## Which enzyme metabolises ergot alkaloids and is behind their dangerous interactions? CYP3A4; its strong inhibitors raise ergot levels and can cause ergotism. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/ergometrine/) ## Related drugs - [Methylergometrine](https://durgical.com/en/pharmacology/methylergometrine/) - [Oxytocin](https://durgical.com/en/pharmacology/oxytocin/) - [Misoprostol](https://durgical.com/en/pharmacology/misoprostol/) ## Related conditions - [Postpartum haemorrhage](https://durgical.com/en/conditions/postpartum-haemorrhage/) [← Back to the class: Ergot alkaloids](https://durgical.com/en/pharmacology/classes/ergot-alkaloids/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/medicines/239) (World Health Organization, 2025); [WHO recommendations: uterotonics for the prevention of postpartum haemorrhage](https://www.who.int/publications/i/item/9789241550420) (World Health Organization, 2018); [DailyMed - METHYLERGONOVINE MALEATE injection, solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9a3079e-b62b-4858-920e-d8f5cb38481e) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=G02AB) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/ergometrine/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/ergometrine/