CYP3A 4 inhibitors- 
Methylergomovine should not be coadministered with potent CYP3A4  inhibitors
eg macrolide antibiotics eg clarithromycin, erythromycin, troleandomycin,
HIV protease or reverse transcriptase inhibitors, eg delavardine, indinavir, nelfanavir, ritovir
or azole antifunfangals-ketoconazole, itraconazole, voriconazole

Vasoconstrictors/ergot alkaloids- excercise caution when methylergonovine is used concurrently
with vasoconstrictors or ergot alkaloids

Uterine contractions

Most common-
Hypertension in several cases wih seizure or headache
Hypotension also reported

Nausea and vomiting occurred occassionally

Rarely-
Acute myocardial infarction, transceint chest pain, dyspnea, hematuria, thrombophelbitis
water intoxication, hallucinations, leg cramps, dizziness, tinnitus, nasal congection,
diarrhoea, palpitation and foul taste

Certain ergot alkaloids are contraindicated for concomittant use with potent CYP3A4 inhibotors
eg , macrolide antibitotics, azo eantifungals,

CYP3A4 inhibitors should not be used concomittantly with methylergonovine

Special precautions-
Special risk-  caution should be excercised in presence of sepsis, obliterative vascular disease
 hepatic or renal involvement

Use with caution during the second stage of labor

Pregnancy-  use of methylergonovine maleate is contraindicated during pregnancy becuase of
utertonic effects

Labor and delivery- the uterotonic effect of methylergonovine maleate  is utilized after delivery
to assist involution and decrease hemorrhage, shortening the third stage of labor

Lactation-caution should be excercised when methylergovine maleate is administered
to a nursing women.

Children - safety and efficacy in children patients have not been established
 

Indication-
Uterine contractions

Dosage-
1 tablet 0.2mg 3 to 4 times a daliy in the puerperium for a maximum of 1 week

Pregnancy- 
Use of methylergonovine maleate is contraindicated during pregnancy becuase of
utertonic effects

Labor and delivery-
The uterotonic effect of methylergonovine maleate  is utilized after delivery
to assist involution and decrease hemorrhage, shortening the third stage of labor

Lactation-
Caution should be excercised when methylergovine maleate is administered
to a nursing women.

Children -
Safety and efficacy in children patients have not been established