Atosiban

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[edit] BRAND NAMES

[edit] STRUCTURE

Atosiban.jpg

[edit] MECHANISM OF ACTION

Atosiban is a competitive antagonist of human hormones oxytocin and vasopressin. Atosiban decreases the frequency of contractions and the tone of the uterine musculature, resulting in a suppression of uterine contractions. In animals atosiban did not exhibit cardiovascular effects.

[edit] INDICATIONS

Tractocile is indicated to delay imminent pre-term birth in pregnant adult women with:

  • regular uterine contractions of at least 30 seconds duration at a rate of ≥ 4 per 30 minutes
  • a cervical dilation of 1 to 3 cm (0-3 for nulliparas) and effacement of ≥ 50%
  • a gestational age from 24 until 33 completed weeks
  • a normal fetal heart rate

[edit] DOSAGE

Initially 6.75 mg bolus dose via slow IV over 1 min, followed by continuous IV infusion at 18 mg/hour for 3 hours. Thereafter, administer 6 mg/hour via continuous IV infusion up to 45 hours. The duration of the treatment should not exceed 48 hours. The total dose given during a full course of Tractocile therapy should preferably not exceed 330.75 mg of atosiban.

[edit] CONTRAINDICATIONS

  • Gestational age below 24 or over 33 completed weeks
  • Premature rupture of the membranes >30 weeks of gestation
  • Abnormal fetal heart rate
  • Antepartum uterine hemorrhage requiring immediate delivery
  • Eclampsia and severe pre-eclampsia requiring delivery
  • Intrauterine fetal death
  • Suspected intrauterine infection
  • Placenta praevia (an obstetric complication in which the placenta is inserted partially or wholly in lower uterine segment)
  • Abruptio placenta (the placenta partially or completely separates from the lining of your uterus)
  • Any other conditions of the mother or fetus, in which continuation of pregnancy is hazardous
  • Hypersensitivity to the active substance(s) or to any of the excipients

[edit] PRECAUTIONS

[edit] INTERACTIONS

[edit] PREGNANCY AND LACTATION

Atosiban should only be used when pre-term labour has been diagnosed between 24 and 33 completed weeks of gestation. If during pregnancy the woman is already breast-feeding an earlier child, then breast-feeding should be discontinued during treatment with Atosiban , since the release of oxytocin during breast-feeding may augment uterine contractility, and may counteract the effect of tocolytic therapy.

[edit] SIDE EFFECTS

  • Very common (>10%): nausea.
  • Common (1-10%): headache, dizziness, hot flushes, vomiting, Hyperglycemia, tachycardia, hypotension, injection site reaction and hyperglycemia.
  • Uncommon (0.1%-1%): fever, insomnia, pruritus, rash.
  • Rare (<0.1%): incidental cases of uterine hemorrhage/uterine atony and one case of allergic reaction were reported.

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES