What are the adverse effects of Atosiban?

Adverse Effects of Atosiban

Atosiban has a favorable safety profile with minimal maternal-fetal side effects compared to other tocolytic agents, with the most common adverse effects being injection site reactions, nausea, vertigo, and transient flushing.

Common Adverse Effects

• Injection site reactions occur in 5-20% of patients receiving atosiban 1, 2
• Nausea, vertigo, and flushing may occur during initial bolus administration in approximately 20% of patients, typically lasting only 1-2 minutes 1
• Vomiting may occasionally occur during treatment 3
• Headache has been reported in some patients 4

Timing and Frequency of Adverse Effects

• Most adverse effects are observed during the initial bolus administration (20.2% of patients) 1
• During continuous infusion, drug-related side effects decrease significantly to approximately 6% of patients 1
• The majority of side effects are mild and transient, rarely requiring discontinuation of therapy 4

Comparison with Other Tocolytics

• Atosiban demonstrates significantly fewer maternal and fetal adverse events compared to beta-agonists and other tocolytic agents 5, 2
• Unlike beta-agonists such as hexoprenaline, atosiban rarely causes:
  • Maternal tachycardia (7.7% with atosiban vs. 76.9% with hexoprenaline) 2
  • Hypertension (7.7% with atosiban vs. 23.1% with hexoprenaline) 2
  • Palpitations (0% with atosiban vs. 76.9% with hexoprenaline) 2

Rare Adverse Effects

• Dysguesia (altered taste) has been reported in rare cases 4
• Chest pain has been reported in isolated cases 4
• Diarrhea may occur in some patients 3

Special Considerations

• In patients treated before 24 weeks gestation, there have been reports of higher fetal-infant deaths compared to placebo, though data at this gestational age are inconclusive 6
• For gestational ages ≥28 weeks, infant morbidity and mortality rates with atosiban are similar to those with placebo-initiated standard care 6

Monitoring Recommendations

• Monitor for injection site reactions, particularly during initial administration 1, 2
• Observe for signs of nausea, vertigo, and flushing during bolus administration 1
• No specific laboratory monitoring is required during atosiban therapy 1, 5

Advantages Over Other Tocolytics

• The primary benefit of atosiban is its placebo-like maternal-fetal side effect profile 6
• Atosiban's specific action on reproductive tissues results in fewer cardiovascular side effects compared to other tocolytic agents 1, 2
• The medication rarely needs to be discontinued due to adverse effects 4