Medication Dose/Route Rate Considerations Oxytocin 30 units in 500 mL IV or 10 units IM 125-999 mL/hr Titrate to uterine tone Potential fluid overload at total dose > 80 units. Do NOT administer IV push. Methergine 0.2 mg (200 mcg) IM Every 2-4 hours. Up to 5 doses. Hypertension is contraindication. Do not give IV due to sudden hypertension & CVA. Hemabate 0.25 mg (250 mcg) IM or intramyometrial Every 15-90 mins. Up to 8 doses. Asthma is relative contraindication. Misoprostal 800 mcg rectally or 400-600 mcg orally No evidence to support giving more than 800 mcg rectally. Works most effectively when used with other medications. Calcium gluconate 1 ampule IVP 2 ampules in 1 L IV fluid Over 5 mins. Run wide open. Can safely repeat but benefit questionable. Assists with uterine contractility