NDC 55154-9584 Oxytocin

Oxytocin

NDC Product Code 55154-9584

NDC 55154-9584-5

Package Description: 5 VIAL in 1 BAG > 1 mL in 1 VIAL

NDC Product Information

Oxytocin with NDC 55154-9584 is a a human prescription drug product labeled by Cardinal Health. The generic name of Oxytocin is oxytocin. The product's dosage form is injection, solution and is administered via intramuscular; intravenous form.

Labeler Name: Cardinal Health

Dosage Form: Injection, Solution - A liquid preparation containing one or more drug substances dissolved in a suitable solvent or mixture of mutually miscible solvents that is suitable for injection.

Product Type: Human Prescription Drug What kind of product is this?
Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. This data element matches the “Document Type” field of the Structured Product Listing.

Oxytocin Active Ingredient(s)

What is the Active Ingredient(s) List?
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.

  • OXYTOCIN 10 [USP'U]/mL

Inactive Ingredient(s)

About the Inactive Ingredient(s)
The inactive ingredients are all the component of a medicinal product OTHER than the active ingredient(s). The acronym "UNII" stands for “Unique Ingredient Identifier” and is used to identify each inactive ingredient present in a product.

  • CHLOROBUTANOL (UNII: HM4YQM8WRC)
  • ACETIC ACID (UNII: Q40Q9N063P)

Administration Route(s)

What are the Administration Route(s)?
The translation of the route code submitted by the firm, indicating route of administration.

  • Intramuscular - Administration within a muscle.
  • Intravenous - Administration within or into a vein or veins.

Pharmacological Class(es)

What is a Pharmacological Class?
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

  • Increased Uterine Smooth Muscle Contraction or Tone - [PE] (Physiologic Effect)
  • Oxytocic - [EPC] (Established Pharmacologic Class)
  • Oxytocin - [CS]

Product Labeler Information

What is the Labeler Name?
Name of Company corresponding to the labeler code segment of the Product NDC.

Labeler Name: Cardinal Health
Labeler Code: 55154
FDA Application Number: NDA018248 What is the FDA Application Number?
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.

Marketing Category: NDA - A product marketed under an approved New Drug Application. What is the Marketing Category?
Product types are broken down into several potential Marketing Categories, such as NDA/ANDA/BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Start Marketing Date: 08-10-2000 What is the Start Marketing Date?
This is the date that the labeler indicates was the start of its marketing of the drug product.

Listing Expiration Date: 12-31-2021 What is the Listing Expiration Date?
This is the date when the listing record will expire if not updated or certified by the product labeler.

Exclude Flag: N - NO What is the NDC Exclude Flag?
This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA"s requests for correction to deficient or non-compliant submissions ("Y"), or because the listing certification is expired ("E"), or because the listing data was inactivated by FDA ("I"). Values = "Y", "N", "E", or "I".

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Oxytocin Product Labeling Information

The product labeling information includes all published material associated to a drug. Product labeling documents include information like generic names, active ingredients, ingredient strength dosage, routes of administration, appearance, usage, warnings, inactive ingredients, etc.

Product Labeling Index

Other

(SYNTHETIC)FOR INTRAVENOUS INFUSION OR INTRAMUSCULAR USE

Novaplus is a registered trademark of Vizient, Inc.  Manufactured by:Fresenius Kabi USA, LLC Lake Zurich, IL 60047 451126CRevised: September 2019

Description

Each mL of Oxytocin Injection, USP (synthetic), intended for intravenous infusion or intramuscular injection, possesses an oxytocic activity equivalent to 10 USP Oxytocin Units and contains chlorobutanol anhydrous (chloral derivative) 0.5%.  This product may contain up to 12.5% decomposition products/impurities.  Oxytocin injection (synthetic) is a sterile, clear, colorless solution of oxytocin in Water for Injection prepared by synthesis.  Acetic acid may have been added for pH adjustment (pH 3.0-5.0).  The structural formula is:

Clinical Pharmacology

Oxytocin injection (synthetic) acts on the smooth muscle of the uterus to stimulate contractions; response depends on the uterine threshold of excitability.  It exerts a selective action on the smooth musculature of the uterus, particularly toward the end of pregnancy, during labor and immediately following delivery.  Oxytocin stimulates rhythmic contractions of the uterus, increases the frequency of existing contractions and raises the tone of the uterine musculature.  Synthetic oxytocin does not possess the cardiovascular effects, such as elevation of blood pressure, as exhibited by vasopressin found in posterior pituitary injection.

Indications And Usage

IMPORTANT NOTICE:  Oxytocin Injection, USP (synthetic) is indicated for the medical rather than the elective induction of labor.  Available data and information are inadequate to define the benefits to risks considerations in the use of the drug product for elective induction.  Elective induction of labor is defined as the initiation of labor for convenience in an individual with a term pregnancy who is free of medical indications.

Antepartum

Oxytocin injection (synthetic) is indicated for the initiation or improvement of uterine contractions, where this is desirable and considered suitable, in order to achieve early vaginal delivery for fetal or maternal reasons.  It is indicated for (1) induction of labor in patients with a medical indication for the initiation of labor, such as Rh problems, maternal diabetes, pre-eclampsia at or near term, when delivery is in the best interest of mother and fetus or when membranes are prematurely ruptured and delivery is indicated; (2) stimulation or reinforcement of labor, as in selected cases of uterine inertia; (3) adjunctive therapy in the management of incomplete or inevitable abortion.  In the first trimester, curettage is generally considered primary therapy.  In second trimester abortion, oxytocin infusion will often be successful in emptying the uterus.  Other means of therapy, however, may be required in such cases.

Postpartum

Oxytocin injection (synthetic) is indicated to produce uterine contractions during the third stage of labor and to control postpartum bleeding or hemorrhage.

Contraindications

  • Oxytocin injection (synthetic) is contraindicated in any of the following conditions: •Significant cephalopelvic disproportion; •Unfavorable fetal positions or presentations which are undeliverable without conversion prior to delivery, i.e., transverse lies; •In obstetrical emergencies where the benefit-to-risk ratio for either the fetus or the mother favors surgical intervention; •In cases of fetal distress where delivery is not imminent; •Prolonged use in uterine inertia or severe toxemia; •Hypertonic uterine patterns; •Patients with hypersensitivity to the drug; •Induction or augmentation of labor in those cases where vaginal delivery is contraindicated, such as cord presentation or prolapse, total placenta previa, and vasa previa.

Warnings

Oxytocin injection (synthetic) when given for induction or stimulation of labor, must be administered only by the intravenous route and with adequate medical supervision in a hospital.

General

All patients receiving intravenous oxytocin must be under continuous observation by trained personnel with a thorough knowledge of the drug and qualified to identify complications.  A physician qualified to manage any complications should be immediately available.When properly administered, oxytocin should stimulate uterine contractions similar to those seen in normal labor.  Overstimulation of the uterus by improper administration can be hazardous to both mother and fetus.  Even with proper administration and adequate supervision, hypertonic contractions can occur in patients whose uteri are hypersensitive to oxytocin.Except in unusual circumstances, oxytocin should not be administered in the following conditions: prematurity, borderline cephalopelvic disproportion, previous major surgery on the cervix or uterus including caesarean section, overdistention of the uterus, grand multiparity or invasive cervical carcinoma.  Because of the variability of the combinations of factors which may be present in the conditions above, the definition of ‘‘unusual circumstances’’ must be left to the judgement of the physician.  The decision can only be made by carefully weighing the potential benefits which oxytocin can provide in a given case against rare but definite potential for the drug to produce hypertonicity or tetanic spasm.Maternal deaths due to hypertensive episodes, subarachnoid hemorrhage, rupture of the uterus and fetal deaths due to various causes have been reported associated with the use of parenteral oxytocic drugs for induction of labor and for augmentation in the first and second stages of labor.Oxytocin has been shown to have an intrinsic antidiuretic effect, acting to increase water reabsorption from the glomerular filtrate.  Consideration should, therefore, be given to the possibility of water intoxication, particularly when oxytocin is administered continuously by infusion and the patient is receiving fluids by mouth.

Drug Interactions

Severe hypertension has been reported when oxytocin was given three to four hours following prophylactic administration of a vasoconstrictor in conjunction with caudal block anesthesia.  Cyclopropane anesthesia may modify oxytocin’s cardiovascular effects, so as to produce unexpected results such as hypotension.  Maternal sinus bradycardia with abnormal atrioventricular rhythms has also been noted when oxytocin was used concomitantly with cyclopropane anesthesia.

Carcinogenesis, Mutagenesis, Impairment Of Fertility

There are no animal or human studies on the carcinogenicity and mutagenicity of this drug, nor is there any information on its effect on fertility.

Pregnancy Category C.

There are no known indications for use of oxytocin in the first and second trimester of pregnancy other than in relation to spontaneous or induced abortion.  Based on the wide experience with this drug and its chemical structure and pharmacological properties, it would not be expected to present a risk of fetal abnormalities when used as indicated.Nonteratogenic Effects—See ADVERSE REACTIONS in the fetus or infant. Labor and Delivery—See INDICATIONS AND USAGE.

Nursing Mothers

It is not known whether this drug is excreted in human milk.  Because many drugs are excreted in human milk, caution should be exercised when oxytocin is administered to a nursing woman.

Adverse Reactions

  • The following adverse reactions have been reported in the mother: •Anaphylactic reaction •Postpartum hemorrhage •Cardiac arrhythmia •Fatal afibrinogenemia •Nausea •Vomiting •Premature ventricular contractions •Pelvic hematomaExcessive dosage or hypersensitivity to the drug may result in uterine hypertonicity, spasm, tetanic contraction or rupture of the uterus.The possibility of increased blood loss and afibrinogenemia should be kept in mind when administering the drug.Severe water intoxication with convulsions and coma has occurred, and is associated with a slow oxytocin infusion over a 24-hour period.  Maternal death due to oxytocin-induced water intoxication has been reported.The following adverse reactions have been reported in the fetus or infant:Due to induced uterine mobility: •Bradycardia •Premature ventricular contractions and other arrhythmias •Permanent CNS or brain damage •Fetal deathDue to use of oxytocin in the mother: •Neonatal retinal hemorrhage •Low Apgar scores at five minutes •Neonatal jaundice

Overdosage

Overdosage with oxytocin injection (synthetic) depends essentially on uterine hyperactivity whether or not due to hypersensitivity to this agent.  Hyperstimulation with strong (hypertonic) or prolonged (tetanic) contractions, or a resting tone of 15 to 20 mm H 2O or more between contractions can lead to tumultuous labor, uterine rupture, cervical and vaginal lacerations, postpartum hemorrhage, uteroplacental hypoperfusion and variable deceleration of fetal heart, fetal hypoxia, hypercapnia or death.  Water intoxication with convulsions, which is caused by the inherent antidiuretic effect of oxytocin, is a serious complication that may occur if large doses (40 to 50 milliunits/minute) are infused for long periods.  Management consists of immediate discontinuation of oxytocin, and symptomatic and supportive therapy.

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.Accurate control of the rate of infusion flow is essential.  An infusion pump or other such device and frequent monitoring of strength of contractions and fetal heart rate are necessary for the safe administration of oxytocin for the induction or stimulation of labor.  If uterine contractions become too powerful, the infusion can be abruptly stopped, and oxytocic stimulation of the uterine musculature will soon wane.An intravenous infusion of a non-oxytocin containing solution should be started.  Physiologic electrolyte solutions should be used except under unusual circumstances.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.  Add the container with dilute oxytocic solution to the system through the use of a constant infusion pump or other such device to control accurately the rate of infusion.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 fetal heart rate, resting uterine tone, and the frequency, duration, and force of contractions should be monitored.The oxytocin infusion should be discontinued immediately in the event of uterine hyperactivity or fetal distress.   Oxygen should be administered to the mother.  The mother and fetus must be evaluated by the responsible physician.

Control Of Postpartum Uterine Bleeding

Intravenous Infusion ( Drip Method)—To control postpartum bleeding, 10 to 40 units of oxytocin may be added to 1,000 mL of a nonhydrating diluent and run at a rate necessary to control uterine atony. Intramuscular Administration—1 mL (10 units) of oxytocin can be given after delivery of the placenta.

Treatment Of Incomplete Or Inevitable Abortion

Intravenous infusion with physiologic saline solution, 500 mL, or 5% dextrose in physiologic saline solution to which 10 units of oxytocin have been added should be infused at a rate of 20 to 40 drops/minute.Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

How Supplied

Oxytocin Injection, USP (synthetic) is supplied as follows:*Packaged in a plastic vial. †The container closure is not made with natural rubber latex. Product CodeUnit of SaleStrengthEachNP91201* NDC 63323-012-12Unit of 25 10 USPUnits/mL NDC 63323-012-211 mL fill in a3 mL vial NP912011† NDC 63323-012-07Unit of 25 10 USPUnits/mL NDC 63323-012-171 mL fill in a2 mL vial Discard unused portion.Use only if solution is clear and seal intact.Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Do not permit to freeze.

Package/Label Display Panel

Oxytocin Injection, USP10 USP units /mLSynthetic5 x 1 mL Vials

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