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Atosiban – Effect, Application & Risks


Atosiban belongs to the group of tocolytics. As an oxytocin antagonist, it inhibits labor and is prescribed to prevent premature birth . The prescription drug is given as an injection and as an intravenous infusion .

What is atosiban?

The contraction inhibitor atosiban is used in obstetric medicine and is intended to help avert the risk of premature birth during pregnancy. It is an ocytoxin antagonist from the group of tocolytics, which inhibits the effects of the two hormones oxytocin and vasopressin .

The colourless, clear liquid is given as a solution for injection and intravenous infusion. One vial of atosiban contains 5 ml of solution.

Certain conditions must be clearly met for the administration of atosiban. The prescription drug may only be used under the supervision of healthcare professionals.

Pharmacological action

Atosiban is a synthetic structural analogue of the neuropeptide oxytocin that is present in the body. As a competitive oxytocin antagonist, the drug acts on the oxytocin receptors in the myometrium .

It also binds to the vasopressin V1a receptor, thereby inhibiting the action of vasopressin. In this case, the release of Ca2+ ions from intracellular stores in the sarcoplasmic reticulum is inhibited.

Blocking the influx of Ca2+ ions into the myometrial cell inhibits the intracellular increase in Ca2+ needed for uterine contraction . The degree of inhibition of uterine contractions depends on the dose of atosiban administered.

After the binding of atosiban and its anti-contracting effect, which has taken place as described, the contraction frequency and the tone of the uterine muscles decrease, and the uterus is immobilized. The recommended dose of atosiban can immobilize the uterus for up to twelve hours.

Medical Application & Use

Around two thirds of all preterm births are caused by premature labour, premature rupture of membranes or cervical insufficiency . Atosiban is used in premature labor.

Certain criteria must be met for the administration of atosiban, namely: regular contractions of the uterus lasting at least 30 seconds and with a frequency of more than four contractions within 30 minutes; dilated cervix to a width of one to three centimeters (zero to three centimeters in primiparous women); Cervical elapse of more than 50% within 24 to 33 completed weeks of pregnancy; Pregnant women over the age of 18; Fetus with regular heart rate .

Atosiban requires a prescription and is given in the hospital by a doctor, midwife or other healthcare professional. The dose is determined by the doctor.

The drug is delivered intravenously in three consecutive stages: The first injection is given slowly over a period of over a minute into the vein . The recommended dose is 6.75 mg in 0.9 ml. The agent then runs as a continuous infusion through a drip for over three hours. The recommended hourly dose is 18 mg. A reduced dose of atosiban to the recommended 6 mg hourly is followed for a maximum of 45 hours or until uterine contractions subside. There should be no more than three repetitions of treatment per pregnancy.

Atosiban is contraindicated in certain diseases or conditions, as shown in this overview: Allergy to drug components; outside the 24th to 33rd week of pregnancy; amniotic sac rupture; irregular heart rate of the fetus; vaginal bleeding ; eclampsia or severe preeclampsia ; uterine infection ; loose placenta or obscuring the birth canal ; deceased fetus; risky continuation of pregnancy.

Risks & side effects

Various side effects can occur when using atosiban. Disorders of well-being such as dizziness , nausea , vomiting , headaches and hot flashes have been observed in isolated cases . In addition, an increased heart rate, reduced blood pressure , increased blood sugar levels and reactions at the injection site could occur. Occasionally, skin rashes , itching , fever , or insomnia have occurred . Atosiban should only be used after a detailed medical consultation. 

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.