When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to methylergonovine, or if you have high blood pressure or toxemia. If you are pregnant, you should be given this medicine only if you are in labor.

How to Use This Medicine:
Injectable

• A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given as a shot into a muscle or into a vein. This medicine is usually given after delivery of the placenta or during the second stage of labor.
• Your doctor may also prescribe methylergonovine tablets for you to take. Be sure to follow all your doctor's instructions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using another ergot medicine (such as ergotamine, Cafergot®, Ergomar®, Wigraine®) or a blood pressure medicine (such as atenolol, metoprolol, propranolol, Bystolic®, Tenormin®).
• Make sure your doctor knows if you are also using medicine to treat an infection (such as clarithromycin, clotrimazole, erythromycin, fluconazole, itraconazole, ketoconazole, troleandomycin, voriconazole, Biaxin®, Diflucan®, Ery-tab®, Nizoral®), medicine to treat HIV infection (such as delavirdine, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir, Norvir®, Rescriptor®), or medicine to treat depression (such as fluoxetine, fluvoxamine, nefazodone, Serzone®). Tell your doctor if you are also using rifampicin (Rifadin®, Rimactane®), zileuton (Zyflo®) or medicine to treat severe chest pain or angina (such as nitroglycerin, Nitro-Bid®, Nitrostat®, Transderm-Nitro®).
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Warnings While Using This Medicine:

• Your unborn baby could be harmed if you use this medicine before you go into labor. This medicine may cause contractions of the uterus and cause you to give birth early.
• Do not breastfeed for at least 12 hours after your last dose of this medicine.
• Make sure your doctor knows if you have kidney disease, liver disease, heart disease (such as coronary artery disease), or blood vessel disease.
• This medicine may increase your chance of heart problems or a heart attack. This is more likely if you already have heart disease, if you have diabetes or high cholesterol, or if you smoke or are overweight. Call your doctor right away if you have chest pain or discomfort; nausea or vomiting; pain or discomfort in the arms, jaw, back, or neck; or trouble breathing.
• Your doctor will check your progress closely while you are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain or discomfort, fast or uneven heartbeat, sweating, trouble breathing, or pain in the arm, back, or jaw
• Decrease in how much or how often you urinate
• Seizures
• Severe headache, blurred vision
• Tingling of the fingers, toes, or feet

If you notice these less serious side effects, talk with your doctor:

• Diarrhea, nausea, vomiting, stomach pain

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088