Posterior pituitary hormones
Brand names: Pitocin, Syntocinon
Updated · Methodology
First line
First-line for labor induction and augmentation per 2009/2021 and NG207. IV via infusion pump, start 1–2 mU/min and titrate every 15–30 minutes to adequate contractions (3–5 per 10 minutes). Max 30–40 mU/min. Hospital use only with continuous fetal and maternal monitoring – hyperstimulation with fetal distress risk.
Sources
ICD-10: O61 · ICD-11: JB01
First line
First-line for prevention and treatment of uterine atony postpartum hemorrhage per 2022 and FIGO 2018. Prophylaxis: 10 IU IM or 5 IU IV immediately after birth. Treatment: 20–40 IU in 1 L saline IV drip, combined with methylergometrine, misoprostol, or carboprost as needed. Tranexamic acid is added for persistent bleeding.
Sources
ICD-10: O72 · ICD-11: JA43
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Oxytocin is a hormone used in medicine to induce labor and to manage postpartum hemorrhage. Nasal and injectable forms are marketed for relationships, intimacy, and anxiety reduction. These uses have been studied: large RCTs and meta-analyses of oxytocin for anxiety and social behavior, including a double-blind placebo-controlled autism trial (Sikich, NEJM 2021), showed no benefit. International guidelines do not support nasal oxytocin for anxiety. For anxiety, proven help comes from psychotherapy and, where indicated, SSRIs; oxytocin should not replace them.
«Oxytocin for bonding and trust» — a marketed claim, not clinical.
Sources
ICD-10: F41.9 · ICD-11: 6B0Z
Synthetic analog of endogenous oxytocin — a posterior pituitary peptide hormone. Binds myometrial oxytocin receptors, which markedly upregulate near term. Causes rhythmic uterine contractions identical to labor. In breast tissue, it contracts alveolar myoepithelial cells, ejecting milk. Short half-life (3–5 minutes) allows precise titration via IV infusion.
Used exclusively during labor and for postpartum hemorrhage. Contraindicated in early pregnancy.
Compatible with breastfeeding, supports milk ejection. Intranasal forms for lactation stimulation exist but are not first-line in current guidelines.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Verbatim lines from the interaction sections, in the language of the label
«Medicamentos que prolongan el intervalo QT: La oxitocina se debe considerar como potencialmente arritmogénica, particularmente en pacientes con otros factores de riesgo de Torsades de Pointes , como…»AEMPS, section 4.5 · Open on CIMA
«Vasoconstrictores/AEMPS, section 4.5 · Open on CIMA
«Vasoconstrictores/AEMPS, section 4.5 · Open on CIMA
«Asimismo, la L-dopa, la L-tiroxina, la oxitocina y el alcohol pueden alterar la tolerancia cardíaca a los β 2 simpaticomiméticos.»AEMPS, section 4.5 · Open on CIMA
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Oxytocin is evaluated for the following indications with varying evidence strength: Postpartum hemorrhage (evidence tier A), Labor induction (evidence tier A), Stress and anxiety (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Oxytocin (≥ 1 in 100): Nausea, vomiting, Maternal tachycardia, Headache, Uterine hyperstimulation. See the Safety section for uncommon and serious reactions.
Used exclusively during labor and for postpartum hemorrhage. Contraindicated in early pregnancy.
Compatible with breastfeeding, supports milk ejection. Intranasal forms for lactation stimulation exist but are not first-line in current guidelines.
Oxytocin is contraindicated in: Cephalopelvic disproportion; Transverse fetal lie; Fetal distress before induction; Preeclampsia with uncontrolled severe hypertension; Uterine hypertonia. Full list in the Safety section.
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