Oxytocin is a synthetic hormone medication used to help with breastfeeding and milk expression. It is also commonly used to induce or strengthen uterine contractions during labor.
In the United States, this medication is most frequently used in hospital settings as an injectable under the brand name Pitocin. While it also exists as a nasal spray, its use is strictly regulated by healthcare providers.
Oxytocin must be administered under the direct supervision of an obstetrician or qualified medical professional. Your doctor will determine the exact dosage and duration of treatment based on your specific clinical needs.
What it is used for
Oxytocin is indicated for the following purposes:
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Stimulating the production of breast milk.
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Helping the breasts release milk during expression.
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Treating breast engorgement or plugged milk ducts.
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Inducing labor in cases of post-term pregnancy, premature rupture of membranes, or pre-eclampsia.
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Strengthening contractions in cases of uterine inertia (when the uterus does not contract sufficiently).
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Assisting in the management of incomplete, inevitable, or missed abortions.
Additionally, injectable oxytocin is used in hospitals to prevent and treat postpartum hemorrhage and may be used to help prevent mastitis.
How to use
The administration of oxytocin depends on the specific form prescribed, which includes:
1. Oxytocin nasal spray
Oxytocin nasal spray (40 USP units/mL) is administered by gently inhaling the spray through the nostrils. The typical dose is one spray into the nostril approximately 2 to 5 minutes before breastfeeding or using a breast pump.
The length of treatment for the nasal spray is determined by a physician on an individual basis. Once opened, the bottle should be stored in the refrigerator and discarded after one month.
2. Injectable oxytocin
Injectable oxytocin (10 USP units/mL) is administered directly into a vein (IV) or muscle (IM) by a healthcare professional. This is performed exclusively in a hospital setting under obstetric supervision.
Standard dosing involves diluting the medication in an electrolyte solution and administering it via a slow intravenous infusion to monitor the body's response safely.
3. Sublingual oxytocin
Sublingual oxytocin consists of compounded tablets placed under the tongue until they dissolve. These tablets usually contain between 10 USP and 100 USP units and are taken according to a doctor's specific instructions.
It is important to note that sublingual oxytocin is not an FDA-approved method of administration. There is currently limited scientific evidence to confirm its safety or effectiveness when taken this way.
Possible side effects
The most common side effects associated with the nasal spray include painful uterine cramps, headaches, nausea, skin rashes, or nasal irritation.
Injectable oxytocin may cause a sudden drop in blood pressure or an increased heart rate, particularly if the medication is administered too quickly.
When used in high doses, oxytocin can overstimulate the uterus. This may lead to serious complications such as fetal distress, oxygen deprivation (asphyxia), fetal death, uterine rupture, or overly intense contractions (tetany).
Who should not use it
The nasal spray should not be used by children or pregnant women outside of controlled medical indications, as it can trigger labor or premature contractions. Individuals with a known latex allergy should also avoid the spray, as it may cause severe allergic reactions or anaphylactic shock.
Injectable oxytocin is contraindicated in several specific medical situations, including:
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Uterine hypertonicity (contractions that are too frequent or intense).
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Fetal distress or abnormal fetal positioning.
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Placental abruption or placenta previa.
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Umbilical cord prolapse.
It is also generally avoided in cases of multiple pregnancies (like twins), the presence of certain C-section scars, or if the baby’s head is too large to pass through the mother’s pelvis (cephalopelvic disproportion).