(1994; 52 pages)
Conclusions and recommendations
Oral ergometrine (E) and methylergometrine (ME) tablets and buccal oxytocin (OT) and desamino-oxytocin (DOT) tablets are not stable under simulated tropical conditions, and are therefore not suitable for use in the prevention of PPH in tropical climates. It is unlikely that the serious instability of E and ME under simulated tropical conditions can be improved by a different formulation. Moreover, pharmacokinetic data on buccal OT and DOT seem far from reliable (40). Pharmacokinetic studies on buccal OT and DOT (33-37) and the data obtained in this study on their stability do not justify efforts to improve their stability.
Injectable oxytocin therefore remains the best choice of oxytocic for prophylactic use in the prevention of PPH, although its intramuscular route of administration is not ideal. Investigation of the possibility of formulating and manufacturing a stable non-injectable alternative to oxytocin is recommended.