Drug reference

Oxytocin

Posterior pituitary hormone / uterotonic · Uterotonic, Induction/Augmentation of Labor, Postpartum Hemorrhage Prophylaxis/Treatment

Also known as Syntocinon, Pitocin

START

Induction IV 1–2 mU/min, titrate q30 min to adequate contractions; PPH 10 IU IM / 5 IU slow IV

TYPICAL MAX

Induction usually ≤20 mU/min; PPH treatment infusion up to 40 IU diluted

STOP IF

Uterine tachysystole/hyperstimulation, fetal distress, signs of water intoxication

WATCH

Continuous fetal heart rate + uterine activity, fluid balance/sodium (prolonged infusion), BP/HR (avoid rapid bolus)

CDSCO approvedSchedule HJan AushadhiATC H01BB02

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 1min · IV onset (~1 min)
PEAK: 5min · uterine peak
t½: 4min · plasma t½ (~4 min)
DURATION: 20min · IV offset (~20 min)

EXCRETION

Oxytocinase degradation; minor renal

route + CYP

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Indicated in pregnancy for appropriate obstetric use (labour/PPH) under monitoring — not for elective non-medical induction

FDA category + note

Top interactionssee all 12 →

Intravenous FluidsSevereTextbookKDT 7e · p330, p331, p333
AmiodaroneSevereDatabaseDDInter
AmisulprideSevereDatabaseDDInter
AnagrelideSevereDatabaseDDInter

Available in India

26 branded formulations. Look up specific brands in the Drugs workspace.

Jan Aushadhi — generic available at GoI pharmacies

Mechanism

Binds uterine oxytocin receptors increasing intracellular calcium → rhythmic myometrial contraction (term-sensitised); stimulates myoepithelial milk ejection; mild antidiuretic (vasopressin-like) at high doses.

Indications

Induction/augmentation of labourPrevention and treatment of postpartum haemorrhage (active third-stage management)Control of postpartum uterine bleeding/atonyAdjunct in incomplete/missed abortion

Dosing

Adult: Labour induction: IV infusion 1–2 mU/min, increase by 1–2 mU/min every 30 min to effective contractions (usually ≤20 mU/min). PPH prevention: 10 IU IM or 5 IU slow IV after delivery; treatment: infusion 10–40 IU in 500–1000 mL.
Pediatric: Not applicable.
Renal adjustment: No specific adjustment (caution: water intoxication with high-dose dilute infusion).
Hepatic adjustment: No specific adjustment.
Geriatric: Not applicable (obstetric).
Max dose: Induction generally ≤20 mU/min; avoid prolonged high-dose (water intoxication)

Pharmacokinetics

Onset

IV ~1 min; IM 3–5 min

Peak effect

Uterine response rapid (IV)

Duration

IV ~20 min after stopping; IM ~30–60 min

Half-life

~1–6 min

Bioavailability

IV/IM (peptide; not oral)

Protein binding

Low

Metabolism

Hepatic/renal oxytocinase; placental

Excretion

Renal (small unchanged)

Contraindications

Significant cephalopelvic disproportion / unfavourable fetal position
Hypertonic/obstructed labour, fetal distress where delivery not imminent
Prior classical uterine incision / high rupture risk
Hypersensitivity to oxytocin

Side effects

Common

Uterine hyperstimulation/tachysystoleNausea/vomitingTransient hypotension/tachycardia (rapid IV)Headache

Serious

Uterine rupture/hyperstimulation → fetal distress/asphyxia
Water intoxication/hyponatraemia (prolonged high-dose dilute infusion)
Severe hypotension/arrhythmia (rapid undiluted IV bolus)
Postpartum haemorrhage from uterine atony after over-stimulation; anaphylaxis

Pregnancy & lactation

Pregnancy

Indicated in pregnancy for appropriate obstetric use (labour/PPH) under monitoring — not for elective non-medical induction

Lactation

Compatible — endogenous role in lactation; not orally active in infant

Drug interactions

Intravenous Fluids

Severe

Textbook

Water intoxication and pulmonary edema can occur, which is a serious and potentially fatal complication.

Large amounts of intravenous fluids and oxytocin should not be infused together. The volume of intravenous infusion should be kept to a minimum to avoid fluid overload.

Source: KDT 7e · p330, p331, p333

Amiodarone

Severe

Database

Drug interaction classified as: synergy.

Source: DDInter

Amisulpride

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Anagrelide