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Other strengths and forms by Beacon Pharmaceuticals PLC
Indications & Uses
Atosiban Acetate is used to delay imminent pre-term birth in pregnant adult women who meet all of these conditions: regular uterine contractions lasting at least 30 seconds each, at a rate of ≥4 per 30 minutes, a cervical dilation of 1 to 3 cm (0 to 3 for nulliparas) with effacement of ≥50%, a gestational age from 24 until 33 completed weeks, and a normal fetal heart rate.
Pharmacology
Atosiban binds to oxytocin receptors that sit in the membrane of the myometrium (the uterine muscle). By doing so, it stops oxytocin from raising the production of inositol triphosphate. Without that rise, the stored calcium in the sarcoplasmic reticulum isn't released, and the voltage gated calcium channels don't open afterwards. Calcium inside the cell therefore doesn't increase, and the uterine muscle doesn't contract. The contractions become less frequent and the uterus settles into a quiet state (uterine quiescence).
More recently, atosiban has been found to act as a biased ligand at oxytocin receptors. It blocks Gq coupling, which explains the inhibition of the inositol triphosphate pathway thought to be responsible for the effect on uterine contraction. But it acts as an agonist of Gi coupling. This agonism produces a pro-inflammatory effect in the human amnion by activating the pro-inflammatory signal tranducer NF-κB. It is thought that this makes atosiban less effective than agents that do not cause inflammation, because inflammatory mediators are known to play a role in the induction of labour.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Atosiban is given into a vein in three stages. First comes a single bolus dose of 6.75 mg, using Atosiban 6.75 mg/0.9 ml solution for injection. Straight after that, a loading infusion of 300 micrograms/min is started using Atosiban 37.5 mg/5 ml concentrate for solution for infusion, and this runs for three hours. The third stage is a lower dose of the same Atosiban 37.5 mg/5 ml concentrate (the subsequent infusion, 100 micrograms/min), which can continue for up to 45 hours.
The treatment should not go beyond 48 hours. Across a full course of Atosiban therapy, the total dose should preferably not be more than 330.75 mg of atosiban.
Side Effects
The most common side effect of Atosiban Acetate is feeling sick (nausea). This is very common and affects more than 1 in 10 people. Common side effects affect less than 1 in 10 people. These are headache, feeling dizzy, hot flushes, being sick (vomiting), fast heartbeat, and low blood pressure. The signs of low blood pressure may include feeling dizzy or light-headed. Also common are a reaction at the site where the injection was given, and high blood sugar. Uncommon side effects affect less than 1 in 100 people. These are high temperature (fever), difficulty sleeping (insomnia), itching and rash.
Cautions & Contraindications
Warnings & Precautions
When Atosiban Acetate is given to a patient in whom premature rupture of membranes cannot be excluded, the benefit of delaying delivery should be weighed against the possible risk of chorioamnionitis. There is no experience with Atosiban Acetate in patients with impaired liver or kidney function. A dose adjustment is not likely to be needed in renal impairment, because only a small amount of the medicine is passed out in the urine. In patients with impaired hepatic function, Atosiban Acetate should be used with caution. Experience is limited in multiple pregnancies and in the gestational age group between 24 and 27 weeks, because only a small number of patients have been treated. The benefit of Atosiban Acetate in these groups is therefore uncertain. Re-treatment is possible, but clinical experience with multiple re-treatments is limited, up to 3 re-treatments. In case of intrauterine growth retardation, whether to continue or restart Atosiban Acetate depends on the assessment of fetal maturity. Uterine contractions and fetal heart rate should be considered for monitoring during administration, and also if the contractions persist. Atosiban Acetate is an antagonist of oxytocin, so in theory it may help the uterus to relax and lead to bleeding after delivery. Blood loss after delivery should therefore be monitored. That said, inadequate contraction of the uterus after delivery was not seen in the clinical trials. Multiple pregnancy, and medicines with tocolytic activity such as calcium channel blockers and beta-mimetics, are known to be linked with a higher risk of pulmonary oedema. For this reason, Atosiban Acetate should be used with caution in multiple pregnancy and/or when other medicines with tocolytic activity are given at the same time.
Contraindications
Atosiban must not be used in the following conditions: gestational age below 24 or over 33 completed weeks, premature rupture of the membranes at over 30 weeks of gestation, abnormal foetal heart rate, antepartum uterine haemorrhage requiring immediate delivery, eclampsia and severe pre-eclampsia requiring delivery, intrauterine foetal death, suspected intrauterine infection, placenta praevia, abruptio placenta, and any other condition of the mother or foetus in which continuing the pregnancy is hazardous.
Pregnancy & Breastfeeding
If you're pregnant and still breast-feeding an older child, you should stop breast-feeding while you are being given Atosiban.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Storage
Keep Atosiban Acetate in a refrigerator at 2°C to 8°C. Protect it from light and moisture, and keep it out of the reach of children.
Drug Interactions
Common questions about Toco 37.5 mg/5 ml
What is Toco 37.5 mg/5 ml IV Infusion?
Toco 37.5 mg/5 ml IV Infusion is a medicine that contains Atosiban Acetate. It is made by Beacon Pharmaceuticals PLC. It belongs to the Other preparations group of medicines.
What is Toco used for?
Atosiban Acetate is used to delay imminent pre-term birth in pregnant adult women who meet all of these conditions: regular uterine contractions lasting at least 30 seconds each, at a rate of ≥4 per 30 minutes, a cervical dilation of 1 to 3 cm (0 to 3 for nulliparas) with effacement of ≥50%, a gestational age from 24 until 33 completed weeks, and a normal fetal heart rate.
What are the side effects of Toco?
The most common side effect of Atosiban Acetate is feeling sick (nausea). This is very common and affects more than 1 in 10 people.
Can I take Toco during pregnancy or while breastfeeding?
If you're pregnant and still breast-feeding an older child, you should stop breast-feeding while you are being given Atosiban. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Toco?
Keep Atosiban Acetate in a refrigerator at 2°C to 8°C. Protect it from light and moisture, and keep it out of the reach of children.
Can I take other medicines with Toco?
Some medicines can interact with Atosiban Acetate, for example: Betamethasone. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Toco?
Toco is a prescription (Rx) medicine. Take it as your doctor advises.