Table 1

Summary of clinical indications and health system requirements of uterotonics and tranexamic acid

Use and health system requirementsUterotonicsNon-uterotonic
OxytocinMisoprostolHeat-stable carbetocin*Ergometrine†Tranexamic acid
PPH preventionRecommended‡RecommendedRecommendedRecommendedNot recommended
PPH treatmentRecommended‡RecommendedNot recommendedRecommendedRecommended
Labour inductionRecommendedRecommendedNot recommendedContraindicatedNot recommended
Labour augmentationRecommendedContraindicatedContraindicatedContraindicatedNot recommended
Abortion careNot recommendedRecommended§Not recommendedNot recommendedNot recommended
Postabortion careNot recommendedRecommendedNot recommendedNot recommendedNot recommended
Administration routeIntravenous, IMOral, sublingual, vaginal¶Intravenous, IMIntravenous, IMIntravenous
Skilled health provider requirementYesNoYesYesYes
Cold chain transport and storage requirementYes (2°C–8°C)No (but ≤25°C) in double aluminium blistersNo (but ≤30°C)Yes (2°C–8°C) away from lightNo
Presentation**10 IU ampoule200 mcg tablet††100 mcg in 1 mL ampouleErgometrine maleate 0.2 mg/mL in 1 mL ampoule100 mg/mL in 10 mL ampoule
Price per unit**US$0.334
per ampoule		US$0.054 per oral tablet of 200 mcgUS$0.413 per ampouleUS$0.219 per ampouleUS$1.30 per ampoule

  • The colour shadings reflecting a traffic light approach (red, orange and green) were used to give the reader an instant recognition of the level of caution that is needed in regards to the use of the uterotonics and non-uterotonics in different clinical situations. The use of lighter orange and grey in rows 10 and below of table 1 were to help the reader easily identify which uterotonics and non uterotonics required a skilled health provider for their administration and which required a cold chain transport and storage requirement.

  • *Heat-stable carbetocin: only in contexts where its cost is comparable to that of other effective uterotonics.

  • †Ergometrine: only in contexts where hypertensive disorders can be safely ruled out before use. Ergometrine refers to ergometrine/methylergometrine.

  • ‡First line.

  • §Alone or preceded by mifepristone.

  • ¶The vaginal route is not recommended for PPH prevention and treatment.

  • **Per UNFPA Product Catalogue (2021).

  • ††The 25 mcg oral or vaginal tablet is not in the 2021 UNFPA Product Catalogue. The 200 mcg tablet must not be divided into 25 mcg portions, as this is virtually impossible to be achieved precisely by hand.

  • IM, intramuscular; IU, international units; PPH, postpartum haemorrhage; UNFPA, Product Catalogue of the United Nations Population Fund.