misoprostol + oxytocin + methylergonovine

This is a combination of three uterotonic agents—misoprostol, oxytocin, and methylergonovine—used to prevent or treat postpartum hemorrhage (PPH) by promoting uterine contractions. - **Oxytocin** is a peptide hormone that stimulates rhythmic contractions of the upper segment of the myometrium, constricting spiral arteries and reducing blood flow through the uterus. It is considered first-line therapy for PPH[1][4]. - **Methylergonovine** (an ergot alkaloid) induces generalized smooth muscle contraction in the uterus, causing sustained tetanic contractions. It is typically used as a second-line agent due to its potential side effects such as hypertension and nausea[1][4]. - **Misoprostol** is a synthetic prostaglandin E1 analog that increases uterine tone and decreases bleeding by enhancing contractility and vasoconstriction. While effective in resource-limited settings or when other agents are unavailable, it may cause more side effects than conventional uterotonics[1][4]. The combined use of these drugs can be more effective at reducing postpartum blood loss than single-agent therapy but may increase adverse effects such as hypertension or gastrointestinal symptoms[2][6].

Other names

misoprostol plus oxytocin plus methylergonovinemisoprostol/oxytocin/methylergonovine combination