From the FDA Drug Label
DOSAGE AND ADMINISTRATION Dosage of oxytocin is determined by uterine response. The following dosage information is based upon the various regimens and indications in general use. Induction or Stimulation of Labor Intravenous infusion (drip method) is the only acceptable method of administration for the induction or stimulation of labor. To prepare the usual solution for intravenous infusion - one mL (10 units) is combined aseptically with 1,000 mL of a non-hydrating diluent The combined solution, rotated in the infusion bottle to insure thorough mixing, contains 10 mU/mL. The initial dose should be no more than 1 to 2 mU/min The dose may be gradually increased in increments of no more than 1 to 2 mU/min, until a contraction pattern has been established which is similar to normal labor.
The recommended dosage and administration protocol for an oxytocin (oxy) drip intravenous (IV) infusion is:
- Initial dose: 1 to 2 mU/min
- Incremental increase: no more than 1 to 2 mU/min
- Preparation: 1 mL (10 units) combined with 1,000 mL of a non-hydrating diluent, containing 10 mU/mL
- Administration: using a constant infusion pump or other device to control the rate of infusion, with frequent monitoring of uterine contractions and fetal heart rate 1
From the Research
Oxytocin IV infusion should be initiated at a dose of 0.5-2 milliunits/minute and titrated every 15-30 minutes to achieve adequate uterine contractions, not exceeding 40 milliunits/minute, as supported by the most recent study 2. The medication should be administered via an infusion pump for precise control, and prepared by adding 10-30 units of oxytocin to 500-1000 mL of compatible IV fluid (such as normal saline or lactated Ringer's) 2. Some key points to consider when administering oxytocin IV infusion include:
- Continuous monitoring of maternal vital signs, fetal heart rate, and uterine contractions is essential during administration 2.
- The patient should be observed for potential side effects including hyperstimulation of the uterus, water intoxication, hypotension, and tachycardia 2.
- Oxytocin works by binding to receptors in the uterine myometrium, stimulating contractions through increased intracellular calcium 2.
- The medication has a short half-life of 3-5 minutes, allowing for quick titration based on clinical response 2.
- Dosing may need adjustment based on individual patient factors including parity, gestational age, and indication for use (induction of labor versus postpartum hemorrhage management) 2. It's also important to note that combined therapy rather than oxytocin alone should be advised for preventing postpartum hemorrhage, as suggested by a recent study 3. Additionally, carbetocin is probably the most effective agent in reducing blood loss and the need for additional uterotonics, as found in a network meta-analysis 4. However, oxytocin remains the first-line uterotonic agent in the United States for prevention of postpartum hemorrhage, and its use should be guided by the most recent and highest quality evidence available 2.