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Tocolytics are used in preterm labor, which refers to when a baby is born too early before 37 weeks of pregnancy. As preterm birth represents one of the leading causes of neonatal morbidity and mortality, the goal is to prevent neonatal morbidity and mortality through delaying delivery and increasing gestational age by gaining more time for other management strategies like corticosteroids ...
Ritodrine, sold under the brand name Yutopar, is a tocolytic drug used to stop premature labor. [2] [3] This drug has been removed from the US market, according to FDA Orange Book. It was available in oral tablets or as an injection and was typically used as the hydrochloride salt. The drug acts as a selective β 2-adrenergic receptor agonist. [4]
It should not be used to prevent preterm labor or delay labor more than 48–72 hours. In February 2011, the Food and Drug Administration began requiring a black box warning on the drug's label. Pregnant women should not be given injections of the drug terbutaline for the prevention of preterm labor or for long-term (beyond 48–72 hours ...
The FDA ordered the immediate withdrawal of Makena, a drug marketed as a treatment for preterm births, saying it had risks but no benefits for pregnant women.
Hydroxyprogesterone caproate, sold under the brand name Delalutin among others, is a medication used to reduce the risk of preterm birth in women pregnant with one baby who have a history of spontaneous preterm birth. [10] In March 2023, the manufacturer, Covis Pharma, agreed to withdraw the drug from the US market.
In a 2010 meta-analysis, [10] nifedipine is superior to β 2 adrenergic receptor agonists and magnesium sulfate for tocolysis in women with preterm labor (20–36 weeks), but it has been assigned to pregnancy category C by the U.S. Food and Drug Administration, so is not recommended before 20 weeks, or in the first trimester. [9]
Indometacin is an effective tocolytic agent, [21] able to delay premature labor by reducing uterine contractions through inhibition of prostaglandin synthesis in the uterus and possibly through calcium channel blockade. Indometacin readily crosses the placenta and can reduce fetal urine production to treat polyhydramnios.
Nifedipine, sold under the brand name Procardia among others, is a calcium channel blocker medication used to manage angina, high blood pressure, Raynaud's phenomenon, and premature labor. [2] It is one of the treatments of choice for Prinzmetal angina. [2] It may be used to treat severe high blood pressure in pregnancy. [2]