Indications
Atosiban is used in hospital to delay imminent preterm birth (early labour) in adult pregnant women between about 24 and 33 completed weeks of pregnancy who have regular contractions. Delaying birth for a few days gives time for medicines such as Corticosteroids to help the baby’s lungs mature, or for transfer to a hospital with neonatal care.
How It Works
Atosiban blocks the receptors for oxytocin, the natural hormone that makes the muscle of the womb contract during labour. By blocking these receptors, it reduces the strength and frequency of contractions and helps the womb relax.
Dosage and Administration
Atosiban is given only in hospital by a doctor or nurse as an injection into a vein, followed by an infusion (drip), usually for up to 48 hours. The dose and duration are set by the obstetrician, and the mother and baby are monitored throughout. A further course may be given if contractions return.
Interactions
No significant drug interactions are well known. It is not usually combined with other medicines used to stop labour without specialist advice. The medical team will check all other medicines being given.
Contraindications
It is not used before 24 or after 33 completed weeks of pregnancy, when the waters have broken early after 30 weeks, when the baby’s heart rate is abnormal, with bleeding from the womb needing immediate delivery, with eclampsia or severe pre-eclampsia needing delivery, when the baby has died in the womb, with suspected infection of the womb, with placenta previa or placental abruption, or in anyone allergic to Atosiban.
Side Effects
Common effects in the mother include nausea, vomiting, headache, dizziness, hot flushes, fast heartbeat, low blood pressure, raised blood sugar and reactions at the injection site. Less common effects include fever, sleeplessness, itching and rash.
Tell the nurse or doctor at once about chest pain, shortness of breath, severe dizziness, heavy bleeding, or swelling of the face or throat. These are monitored closely in hospital.
Pregnancy and Lactation
Atosiban is used only during pregnancy for preterm labour, under specialist care. Small amounts may pass into breast milk; it is not intended for use after the baby is born.
Precautions and Warnings
Care is needed with twin or multiple pregnancies, liver or kidney problems, or when the waters have broken. The baby’s heartbeat and the mother’s contractions and bleeding are monitored during treatment. If contractions continue, other options will be considered.
Overdose
Few overdose cases are known. Because it is given under hospital supervision, any excess would be managed by stopping the infusion and giving supportive care.
Therapeutic Class
Oxytocin receptor antagonist (tocolytic)
Storage
Hospital medicine: store as directed on the pack, usually in a refrigerator at 2 to 8°C, do not freeze. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.