Posology : מינונים

4.2. Posology and method of administration
Oxytocin should be used only in a clinical setting and only under medical supervision. For the individual dosage, careful monitoring of the birth is required (CTG, blood pressure and pulse of the mother).

Induction or enhancement of labour:
For labour induction or to increase contractions, Oxytocin -Grindeks may only be administered as an intravenous continuous infusion and never as subcutaneous, intramuscular or intravenous bolus injection.
Oxytocin -Grindeks should be administered as an intravenous drip infusion or, preferably, using a variable-speed infusion pump. For drip infusion, it is recommended that 10 IU of Oxytocin -Grindeks should be added to 1000 mL of a physiological electrolyte solution (such as sodium chloride solution 0.9%).
For patients in whom infusion of sodium chloride must be avoided, 5% dextrose sodium may be used as the diluent (see section 4.4 Special warnings and precautions for use). To ensure even mixing, the bottle or bag must be turned upside down several times before use.
The initial infusion rate should be set at 1-4 mU/min (2-8 drops/min). It may be gradually increased at intervals not shorter than 20 min, until a contraction pattern similar to that of normal labour is established. In pregnancy near term, this can often be achieved with an infusion of less than 10 mU/min (20 drops/min), and the recommended maximum rate is 20 mU/min (40 drops/min). In the unusual event that higher rates are required, as may occur in the management of foetal death in utero or for induction of labour at an earlier stage of pregnancy, when the uterus is less sensitive to oxytocin, it is advisable to use a more concentrated Oxytocin -Grindeks solution, e.g., 10 IU in 500 ml.
When using a motor-driven infusion pump, which delivers smaller volumes than those given by drip infusion, the concentration suitable for infusion within the recommended dosage range, must be calculated according to the specifications of the pump.
If regular contractions are still absent after the infusion of 500 mL (5 IU), the attempt at labour induction should be ceased. A fresh attempt can generally be made on the following day.
Throughout the entire duration of infusion, the frequency, intensity and duration of contractions, as well as the foetal heart rate, must be carefully monitored. As soon as appropriate uterine activity has been achieved, the infusion rate can often be reduced. The infusion must be discontinued immediately in the event of excessive uterine activity and/or signs of placental malnutrition (foetal distress).
Caesarean section:
Immediately after extraction of the infant, 5 IU can be injected slowly I.V.
Prevention of postpartum uterine haemorrhage:
The usual dose is 5 IU slowly I.V. after delivery of the placenta. In women given Oxytocin- Grindeks for induction or enhancement of labour, the infusion should be continued at an increased rate during the third stage of labour and for the next few hours thereafter.
Treatment of postpartum uterine haemorrhage:
5-10 IU I.M. or 5 IU slowly I.V., followed in severe cases by intravenous infusion of a solution containing 5-20 IU of oxytocin in 500 ml of a non-hydrating diluent (see section 6.6), run at the rate necessary to control uterine atony.
Due to the antidiuretic effect of Oxytocin -Grindeks which suppresses urine excretion (see section 4.8 Undesirable effects), the following measures should be observed when administering Oxytocin - Grindeks at high doses:
An isotonic sodium chloride solution (not glucose) should be used and the infused volume of fluid must be kept low. At the same time, oral fluid intake should be restricted and the fluid balance monitored. If an electrolyte imbalance is suspected, serum electrolytes must be monitored.
Incomplete, inevitable, or missed abortion:
5 IU I.M. or slowly I.V., if necessary followed by intravenous infusion at a rate of 20-40 mU/min or higher.