Ritopar
Generic Name
Ritodrine Hydrochloride
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ritopar 10 mg tablet | ৳ 8.02 | ৳ 80.20 |
Description
Overview of the medicine
Ritodrine is a beta-2 adrenergic agonist used as a tocolytic agent to inhibit uterine contractions in cases of premature labor, aiming to delay delivery.
Uses & Indications
Dosage
Adults
Intravenous infusion: Initially 50-100 mcg/min, gradually increased by 50 mcg/min every 10 minutes until uterine contractions stop or maximum dose of 350 mcg/min is reached. Oral maintenance: 10 mg every 2 hours for 24 hours, then 10-20 mg every 4-6 hours.
Elderly
Not applicable, primarily used in pregnant women.
Renal_impairment
Use with caution; dose adjustment may be necessary due to renal excretion of the drug and its metabolites.
How to Take
Intravenous infusion should be administered with a controlled infusion pump. Oral tablets should be taken with water, preferably with food to reduce gastrointestinal upset.
Mechanism of Action
Ritodrine selectively stimulates beta-2 adrenergic receptors in uterine smooth muscle, leading to an increase in intracellular cAMP levels. This results in the relaxation of the uterine musculature and inhibition of contractions, thus delaying premature labor.
Pharmacokinetics
Onset
Onset of action is rapid, typically within 5-10 minutes for intravenous administration, and within 30-60 minutes for oral administration.
Excretion
Mainly excreted by the kidneys, primarily as inactive metabolites and some unchanged drug.
Half life
Elimination half-life is biphasic, with an initial phase of 1.3-2.6 hours and a longer terminal phase of 10-20 hours.
Absorption
Well absorbed orally, but significant first-pass metabolism results in variable bioavailability (approx. 30%). Peak plasma concentrations are reached within 30-60 minutes after oral administration.
Metabolism
Primarily metabolized in the liver via conjugation with glucuronic acid.
Side Effects
Contraindications
- Gestation before 20 weeks
- Severe pre-eclampsia or eclampsia
- Intrauterine infection
- Fetal death
- Antepartum hemorrhage requiring immediate delivery
- Cardiac disease, especially arrhythmias or heart failure
- Pulmonary hypertension
- Uncontrolled diabetes mellitus
- Hyperthyroidism
- Known hypersensitivity to ritodrine or other sympathomimetic amines.
Drug Interactions
Beta-blockers
May antagonize the effects of ritodrine.
Corticosteroids
Increased risk of pulmonary edema.
Other sympathomimetics
Additive cardiovascular effects.
Insulin and oral hypoglycemics
Ritodrine may increase blood glucose levels, requiring adjustment of antidiabetic medication.
Halogenated hydrocarbon anesthetics (e.g., halothane)
Increased risk of arrhythmias.
Storage
Store below 30°C in a dry place, protected from light. Do not freeze.
Overdose
Symptoms of overdose include severe tachycardia, palpitations, tremor, nervousness, nausea, vomiting, hypokalemia, hyperglycemia, and potentially pulmonary edema. Management involves immediate discontinuation of the drug, symptomatic and supportive treatment, and close cardiovascular and metabolic monitoring.
Pregnancy & Lactation
Pregnancy: Category B for tocolysis. Used to delay premature labor. Lactation: Ritodrine is excreted in breast milk. Caution is advised, and breastfeeding women should discuss the risks and benefits with their physician.
Side Effects
Contraindications
- Gestation before 20 weeks
- Severe pre-eclampsia or eclampsia
- Intrauterine infection
- Fetal death
- Antepartum hemorrhage requiring immediate delivery
- Cardiac disease, especially arrhythmias or heart failure
- Pulmonary hypertension
- Uncontrolled diabetes mellitus
- Hyperthyroidism
- Known hypersensitivity to ritodrine or other sympathomimetic amines.
Drug Interactions
Beta-blockers
May antagonize the effects of ritodrine.
Corticosteroids
Increased risk of pulmonary edema.
Other sympathomimetics
Additive cardiovascular effects.
Insulin and oral hypoglycemics
Ritodrine may increase blood glucose levels, requiring adjustment of antidiabetic medication.
Halogenated hydrocarbon anesthetics (e.g., halothane)
Increased risk of arrhythmias.
Storage
Store below 30°C in a dry place, protected from light. Do not freeze.
Overdose
Symptoms of overdose include severe tachycardia, palpitations, tremor, nervousness, nausea, vomiting, hypokalemia, hyperglycemia, and potentially pulmonary edema. Management involves immediate discontinuation of the drug, symptomatic and supportive treatment, and close cardiovascular and metabolic monitoring.
Pregnancy & Lactation
Pregnancy: Category B for tocolysis. Used to delay premature labor. Lactation: Ritodrine is excreted in breast milk. Caution is advised, and breastfeeding women should discuss the risks and benefits with their physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved
Patent Status
Patent expired
Clinical Trials
Early clinical trials confirmed the efficacy of ritodrine in delaying premature labor. Subsequent trials, however, highlighted significant cardiovascular side effects in the mother, leading to its decreased use in favor of other tocolytics with better safety profiles.
Lab Monitoring
- Maternal heart rate and blood pressure
- Fetal heart rate
- Blood glucose levels
- Serum electrolytes (especially potassium)
Doctor Notes
- Careful patient selection is crucial, excluding those with cardiac conditions or uncontrolled diabetes.
- Strict monitoring of maternal heart rate, blood pressure, fluid balance, and blood glucose/electrolytes is essential during administration.
- Consider alternative tocolytics with better safety profiles where available.
Patient Guidelines
- Report any unusual symptoms like chest pain, shortness of breath, or severe palpitations immediately to your doctor.
- Do not stop taking the medication suddenly without consulting your doctor.
- Follow the prescribed dosage and administration instructions carefully.
Missed Dose Advice
If an oral dose is missed, take it as soon as remembered, unless it is almost time for the next dose. Do not double the dose.
Driving Precautions
Ritodrine may cause dizziness, tremor, or nervousness. Patients should be advised to assess their response to the drug before driving or operating machinery.
Lifestyle Advice
- Maintain adequate hydration.
- Follow bed rest as advised by your physician.
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