Oxytocin (Pitocin)

Generic Name: Oxytocin (Pitocin)

Pitocin is the brand name of the hormone oxytocin, which stimulates contractions in the uterus.

Oxytocin is sometimes called the “love hormone” because your body releases it at high concentrations during positive social interactions (such as falling in love) or when giving birth.

The drug is used to start or speed up labor contractions during childbirth and control bleeding afterward.

Pitocin may also be used in women who experience an incomplete or inevitable abortion.

The medicine works by increasing the concentration of calcium inside muscle cells. It’s typically injected into a large muscle or given intravenously.

An oxytocin nasal spray is currently under clinical investigation for treating lactation deficiency in nursing moms, autism, and schizophrenia.

Some research has shown that giving oxytocin to women in labor may increase the chance that her baby will have a low APGAR score (a test to check a newborn's condition) and be more likely to be admitted to the neonatal intensive care unit (NICU).

However, other studies have shown the drug doesn’t harm babies and may shorten labor time by nearly two hours.

No health feed found.

Uterine motility depends on the formation of the contractile protein actomyosin under the influence of the Ca2+-dependent phosphorylating enzyme myosin light-chain kinase. Oxytocin promotes contractions by increasing the intracellular Ca2+, which in turn activates myosin's light chain kinase.. Oxytocin has specific receptors in the muscle lining of the uterus and the receptor concentration increases greatly during pregnancy, reaching a maximum in early labor at term.

  • Labor induction: An intravenous infusion of oxytocin is used to induce labor and to support labor in case of slow childbirth if the oxytocin challenge test fails. Whether a high dose is better than a standard dose for labor induction is unclear. It has largely replaced ergometrine as the principal agent to increase uterine tone in acute postpartum haemorrhage. Oxytocin is also used in veterinary medicine to facilitate birth and to stimulate milk release. The tocolytic agent atosiban (Tractocile) acts as an antagonist of oxytocin receptors; this drug is registered in many countries to suppress premature labor between 24 and 33 weeks of gestation. It has fewer side effects than drugs previously used for this purpose (ritodrine, salbutamol, and terbutaline).
  • Help with breastfeeding: Oxytocin is sometimes prescribed for mothers to stimulate breast milk production to help with feeding their baby. However, women receiving intranasal oxytocin daily before breastfeeding produced only slightly more milk after two days.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare

  • Confusion
  • convulsions (seizures)
  • difficulty in breathing
  • dizziness
  • fast or irregular heartbeat
  • headache (continuing or severe)
  • hives
  • pelvic or abdominal pain (severe)
  • skin rash or itching
  • vaginal bleeding (increased or continuing)
  • weakness
  • weight gain (rapid)

Incidence not known

  • Abdominal pain or cramping
  • blood clotting problem that causes prolonged bleeding
  • chest pain or discomfort
  • cough
  • difficulty swallowing
  • extra heartbeats
  • fainting
  • lightheadedness
  • pounding or rapid pulse
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • severe bleeding after giving birth
  • shortness of breath
  • tightness in the chest
  • unusual tiredness or weakness
  • wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  • Restlessness
  • shakiness
  • sleepiness
  • slow to respond
  • slurred speech
  • unconsciousness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

  • Nausea
  • vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Typical Dose For Inducing Labor

An infusion of Pitocin begins by delivering 0.5 milliunits (MU) per minute. The dose is increased by 1 to 2 MU per minute every 15 to 60 minutes until contractions are close to normal.

Typical Dose for Controlling Bleeding After Birth

An infusion delivers 10 MU at a rate of 20 to 40 MU per minute.

Typical Dose for an Inevitable Abortion

An infusion delivers 10 to 20 MU per minute, which is not to exceed 30 MU 12 hours.

Pitocin Overdose

Because oxytocin is given in a medical setting, an overdose is not likely to occur.

However, if you suspect an overdose, you should let your doctor know right away.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems (e.g., subarachnoid hemorrhage) or
  • Hypertension (high blood pressure)—May make these conditions worse.
  • Cephalopelvic disproportion or
  • Cervical cancer or
  • Fetal distress or
  • Grand multiparity (giving birth more than five times) or
  • Major surgery on the cervix or uterus (e.g., caesarean delivery), history of or
  • Overdistended uterus or
  • Premature fetus or
  • Problems with uterine contraction (e.g., uterine atony, strong uterine contractions) or
  • Toxemia, severe or
  • Unfavorable fetal position (e.g., transverse lies) or
  • Other conditions that may require caesarean delivery (e.g., cord prolapse, total placenta previa, vasa previa, or during an emergency)—Should not be used in patients with these conditions.
  • Kidney disease—Use with caution. Effects may be increased because of slower removal of this medicine from the body.

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins or as a shot into one of your muscles.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

No information is available on the relationship of age to the effects of oxytocin in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of oxytocin in geriatric patients.

Pregnancy

Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breastfeeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

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