Oxytocin nasal spray prescription

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There’s a chemical that can subtly shift your childhood memories of your own mother. In some people, it paints mum in a more saintly light, making them remember her as closer and more caring. In others, the chemical has a darker influence, casting mum as a less caring and more distant parent.

All of this becomes heavily ironic when you consider that the chemical in question – a hormone called oxytocin – is often billed as the “hormone of love”, and even marketed as “Liquid Trust”. As a new study shows, the reality is much more complicated. Describing oxytocin as the “hormone of love” is like describing a computer as a “writing tool” – it does other things too, some of which aren’t pleasant.

Oxytocin is a versatile actor, whose resume includes all sorts of jobs in sex, reproduction, social behaviour and emotions. It can increase trust among people and make them more cooperative (this works in meerkats, too). It can increase the social skills of autistic people. It’s released during orgasm. It affects lactating breasts, contracting wombs and the behaviour of sheep mothers towards their newly born lambs. The list goes on: drug addiction, generosity, depression, empathy, learning, memory.

Despite these many roles, oxytocin is often reduced to a misleading label. While “hormone of love” may be great for catchy headlines and compelling marketing slogans, they are ultimately misleading. Jennifer Bartz from the Mount Sinai School of Medicine has found that oxytocin can have completely opposite effects on the way people behave, depending on how they view their relationships to other people.

She recruited 31 men* and asked them to sniff either an oxytocin nasal spray or another spray with the same ingredients minus oxytocin – a placebo. A few weeks later, the sprays were swapped so that the men who took oxytocin now took the placebo, and vice versa. At the time, neither the scientists nor the volunteers knew which was which – that was only revealed after the experiment was over.

Before all of this, the men completed a series of widely used questionnaires to measure the state of their social ties. The questions assessed the nature of their bonds with their families and friends, how sensitive they are to rejection, how comfortable they are at being close to other people, how much they desire that closeness, and more. Shortly after using both sprays, the recruits also answered questions about their mother’s parenting style.

Bartz found that when she averaged out the volunteers’ results, the sniffs of oxytocin hadn’t seemed to colour their memories of their mothers. But things changed when she looked at them individually. Those who felt more anxious about their relationships took a dimmer view of their mother’s parenting styles when they sniffed oxytocin, compared to the placebo. Those who were more secure in their relationships reacted in the opposite way – they remembered mum as being closer and more caring when they took the oxytocin.

These results show that oxytocin is far from being a simple “love hormone”. As Bartz says, it has a “more nuanced role… than previously thought,” and one that varies from person to person. It’s “not an all-purpose attachment panacea.”

For now, Bartz isn’t sure why oxytocin can have such different effects. Her most educated guess is that the hormone triggers a biased trip down memory lane. Under its influence, people are more likely to remember information about their mother that fits with their current attitudes to relationships. If they are anxious, they’re more likely to remember the negative side of their early life. It’s a reasonable enough idea, and one that Bartz intends to test in the future. It will also be good to repeat the study in a larger group – 31 men make for a relatively small study.

But this isn’t the only study to show the subtle side of oxytocin. Just three months ago, I wrote about research from Heejung Kim at the University of California, which showed how oxytocin’s effects vary across different cultures. To fulfil its many roles, oxytocin has to dock at a protein called the ‘oxytocin receptor’, encoded by a gene called OXTR.

Kim found that when Americans who carry a particular version of the OXTR gene are more likely to turn to their friends for support when they are distressed. But Koreans react to social stress in a different way – for them, it’s less socially acceptable to turn to friends for support during tough times. And distressed Koreanswho carry the same version of OXTR are less likely to seek support from their friends.

As I wrote then, “In cases where genes affect our behaviour, the same stretch of DNA can lead to very different deeds, depending on individual circumstances. Just as a production defines a play, environments and cultures alter the effects of certain genes.”

*Bartz only worked with men because there are risks involved in injecting women with oxytocin – if she’s pregnant, it could induce labour, and it might affect the foetus in as yet unknown ways.

Reference: PNAS http://dx.doi.org/10.1073/pnas.1012669107

Photo by Ian Riley

More on oxytocin:

  • How to make meerkats even more sociable

  • Genes and culture: OXTR gene influences social behaviour differently in Americans and Koreans

  • Can a sniff of oxytocin improve the social skills of autistic people?

  • Maternal hormone shuts down baby’s brain cells during birth

Oxytocin’s other side

Oxytocin has been on a joy ride for 20 years, ever since animal studies first linked the hormone to bonding between mother and newborn, as well as between mating adults. Dubbed the “cuddle” or “love” hormone by the popular press, more recently it has earned attention for its role in promoting trust.

One company, Vero Labs in Boca Raton, Fla., has even put it in a cologne-like spray, marketed as “Liquid Trust”: Fifty dollars buys a two-month supply that promises consumers “confidence in a bottle,” according to its website.

But can oxytocin live up to the hype? Research does link it to increased trust, social bonding and even a predisposition to donate to charity. It’s these positive influences that make researchers hopeful that it could help treat mental health disorders, including autismstfdqatt, social anxiety disorder and schizophrenia. Small-scale, preliminary studies show that a sniff of the hormone enables people with autism to better read social cues and allays social anxiety among those with social anxiety disorder. Some physicians are so convinced in the promise of oxytocin, they’ve started prescribing it to children with autism.

That makes oxytocin researchers nervous. Too many questions remain unanswered, including how it works and under what circumstances. On top of those concerns, recent studies suggest that oxytocin may also have a darker side: For some people it might actually decrease trust and sociability and, depending on the context, high levels of the hormone might be a sign that a close relationship is troubled.

“People got carried away with the idea of the cuddle hormone,” says University of California, Los Angeles, psychologist Shelley E. Taylor, PhD. Her work on oxytocin suggests that the hormone is high in women whose relationships are in distress. “It’s never a good idea to map a psychological profile onto a hormone; they don’t have psychological profiles.”

The good and bad

Most hormones don’t influence behavior directly. Rather, they affect thinking and emotions in variable ways. Researchers have several theories about the specific processes that oxytocin engages. In particular, they suggest that by decreasing anxiety and prompting us to get close to someone else, oxytocin allows the brain to pay closer attention to subtle social cues.

“Oxytocin is not the love hormone,” says Larry Young, PhD, of Center for Translational Social Neuroscience at Emory University. “It’s tuning us into social information and allowing us to analyze it at a higher resolution.”

When oxytocin was first discovered in 1909, it was thought mostly to influence a mother’s labor contractions and milk let-down. Then, in the 1990s, research with prairie voles found that giving them a dose of oxytocin resulted in the formation of a bond with their future mate.

Since then, work on oxytocin has exploded in both animals and humans. The number of papers with oxytocin as an index term on PsycINFO increased from just 17 in 1990 to 118 in 2010. Studies are examining not only the specifics of how oxytocin works in the brain, but also its influence on behavior in animals and humans, including bonding, trust, anxiety and social understanding.

In a series of studies, Claremont Graduate University economist Paul Zak, PhD, for example, showed that giving people oxytocin via nasal spray increases their trust of others. He also found that higher levels of oxytocin are associated with giving more money to charity, and, in women, having more friends, having better romantic relationships and having more sex. He calls it the “molecule of connection.”

But new research suggests that oxytocin may also enhance negative social cues. Taylor has evidence that oxytocin rises not only in women who are in good, affectionate relationships, but also in women who have distressed relationships. In the latter case, she believes oxytocin may be signaling the need to seek other social contact.

“We don’t think it’s signaling, ‘stay close to that person,’ it’s signaling ‘stay close to someone’ because your bonds are threatened. Get social contact from somewhere,” Taylor says.

More evidence of oxytocin’s downside comes from Mount Sinai School of Medicine psychologist Jennifer Bartz, PhD. In a study published online in November in Social Cognitive and Affective Neuroscience, she and her colleagues examined whether oxytocin might boost trust and cooperation, as measured with a well-studied economic game, among men and women with borderline personality disorder, who tend to have volatile relationships. She found that rather than increasing trust and teamwork, a dose of oxytocin decreased those feelings compared with a placebo.

In another study, published last December in the Proceedings of the National Academy of Sciences (Vol. 107, No. 48), Bartz found that men who had stable, well-attached relationships remembered their childhood relationship with their mothers as more caring and close when they received oxytocin compared with when they didn’t. In contrast, men who were insecure in their current relationships remembered their childhood relationship with their mothers as less caring and close when they received oxytocin. Of course, the hormone could simply be helping men remember their childhoods more accurately, or it may be coloring their memory search, drawing attention to memories that are more salient to the men based on their current mindset, negative or positive, says Bartz. Only more research will tell.

Controlled substance

Even with so much unknown about how and when oxytocin works, many researchers believe that someday it could be useful for treating disorders that affect people’s ability to relate to one another.

In a brain imaging study, for example, University of Cambridge neuroscientist Pradeep Nathan, PhD, showed that, in people with social anxiety disorder, oxytocin calmed an exaggerated response to fearful faces typically seen in their amygdalas. Although the hormone didn’t have a similar effect on how people actually felt, the researchers suspect it would after more prolonged treatment, just as other psychiatric medications often take time to work. (Neuropsychopharmacology, Vol. 35.)

If further research establishes that oxytocin does have therapeutic value, Young believes it will be best used as part of behavioral treatments in very controlled settings due to its highly context-dependent effect. With a condition such as autism, for example, clinicians might administer oxytocin doses that last about three hours, and work with patients on understanding social cues during that time. The hope is that those social cues will have more meaning for patients while the oxytocin is working and that the learning, in turn, might make lasting changes in the brain.

Still, with so many unknowns, most researchers don’t recommend that people start trying oxytocin to treat themselves or their children. It’s only available through a prescription but, says Young, there have been many rumors suggesting that physicians have started giving it to some people to treat autism as well as social anxiety.

He thinks they’re being premature.

“Most studies in humans give a single dose,” says Young. “There’s no research on what repeated use of the hormone might do.”

Beth Azar is a writer in Portland, Ore.

Oxytocin is a hormone produced by the hypothalamus in the brain and acts primarily as a neurotransmitter in the brain. Oxytocin is best known for its roles in female reproduction however recent studies have begun to investigate oxytocin’s role in various behaviours, including orgasm, social recognition, pair bonding, trust, anxiety, and maternal behaviours. For this reason, it is sometimes referred to as the “cuddle hormone”.

In humans, oxytocin is released during hugging and pleasant physical touch, and plays a part in the human sexual response cycle. Levels of oxytocin are high among people who state they are falling in love, and it seems to also mediate other forms of bonding like friendship and family relationships.

People who have sociophobic behaviours improve after being treated with oxytocin. It appears to change the brain signals related to social recognition via facial expressions, perhaps by changing the firing of the amygdala, the part of the brain that plays a primary role in the processing of important emotional stimuli. In this way, oxytocin in the brain may be a potent mediator of human social behaviour.

Researchers at the University of California, San Diego (UCSD) School of Medicine are studying whether oxytocin might help patients with schizophrenia, social anxiety and a variety of other disorders. It may also help with autism and other conditions where suffers often avoid eye-to-eye gaze, focus on less relavent areas of the face, and avoid meaningful social contact. The UCSD researchers theorize that use of oxytocin might act on the brains of these patients which ultimately increase the level of trust or emotional contact between patient and physician, or with patients and significant others.

A recent study has also reported the benefits of oxytocin for the treatment of autism symptoms. Oxytocin can also affect different anti-stress functions, such as the reduction of blood pressure and cortisol levels, reducing anxiety, and increasing tolerance to pain.

Oxytocin nasal spray is also being investigated for the treatment of migraine headaches with some promising results. The doses used were from 15 to 60iu daily.

We recommend using:

(1) Oxytocin injections subcutaneously (SC) as it is easy to administer yourself at home. We also offer a new needle-free injector for easy, pain free injections. Contact us for details.

(2) Oxytocin Nasal Sprays – Studies have proven oxytocin nasal spray increases serum oxytocin levels which is a convenient and easy way to administer oxytocin. Our laboratory produces a range of sterile oxytocin nasal sprays available with a doctors prescription. It may also be administered sublingually and is also available in this form however we recommend the injection or nasal spray instead as they are the most effective.

What Is Oxytocin?

The so-called “love hormone,” oxytocin plays an important role in pregnancy, birth, and emotional bonding.

Oxytocin is a hormone best known for its roles in childbirth and lactation.

Oxytocin is sometimes referred to as the “love hormone” or “love drug” for its roles in sexual bonding, parenting, and other social behaviors.

Oxytocin in Childbirth

Oxytocin is produced in a part of the brain called the hypothalamus, and is stored in the pituitary gland.

The production of naturally occurring oxytocin in the body helps to stimulate the uterus to contract at the end of pregnancy, signaling the start of childbirth.

Laboratory-made oxytocin, called Pitocin, has been used for many years to help start or strengthen uterine contractions during labor or to reduce bleeding after delivery.

Alternately, drugs that act against oxytocin are often given to help stop premature labor.

Oxytocin also helps to stimulate milk production after birth.

Other Uses of Oxytocin

In recent years, scientific studies of the effects of oxytocin on the brain suggest its role goes well beyond childbirth and lactation.

Studies in laboratory animals and humans suggest that the “love hormone” plays an important role in the establishment of social relationships and behaviors, such as caregiving.

Oxytocin also may have anxiolytic properties, meaning it may help reduce anxiety.

Oxytocin has been promoted as a “wonder drug” that can help enhance positive feelings and social skills while also purportedly alleviating serious cognitive and psychiatric and behavioral conditions, including depression, post-traumatic stress disorder (PTSD), and autism.

However, there’s little clinical evidence to suggest that oxytocin is an effective treatment for psychiatric conditions.

A scientific review published in 2013 suggested that it might help improve communication skills in people with autism spectrum disorders.

Oxytocin Nasal Spray

Oxytocin may be administered either as an injection or a nasal spray.

It’s available by prescription under the brand names Pitocin and Syntocinon.

Nasal sprays are commonly used in medical studies of psychiatric effects, because a nasal spray allows oxytocin to travel more readily from the bloodstream to the brain than an injection.

Oxytocin in Men

Men naturally produce lower levels of oxytocin than women.

Studies of men in monogamous relationships have suggested that in men, the hormone may contribute to fidelity by enhancing their female partner’s attractiveness compared to other women.

More research is needed to determine oxytocin’s effects on men.

Buy Oxytocin Nasal Spray “The Love Hormone” Prescription

The hypothalamus produces a neurotransmitter and a hormone known as oxytocin. It is then transported to and secreted by the pituitary gland, which is located at the base of the brain.

It has a vital role in the reproductive functions of females, from sexual activity to childbirth and nursing. This release is triggered by the stimulation of the nipples.

When a woman is in labor, oxytocin enhances uterine motility, which causes contractions in the muscles of the womb, or uterus. Oxytocin is released as the cervix and vagina begin to widen for labor.

Additionally, oxytocin has social functions, and it affects bonding behavior, social recognition, the creation of group memories, and other social functions.

American Integrative Pharmacy (AIP), led by Dr. Neema Yazdanpanah, provides safe and proven compounding medications to patients in Long Beach, Torrance, Los Angeles, South Bay Orange County, Southern California areas, and online nationwide.

The Love Hormone

According to a 2012 study, people in the initial stages of romantic attachment had higher oxytocin levels in comparison to non-attached single individuals. These levels lasted for a minimum of six months.

Sexual activity also stimulates oxytocin release, and it seems to have a role in erection and orgasm. While the reason for this is not entirely known, in women, it may be that enhanced uterine mobility may assist sperm in reaching their destination. Some believe that there is a correlation between oxytocin concentration and the intensity of orgasm.

Oxytocin and Emotion

Oxytocin appears to influence social interactions as well as relationships between individuals. Upon entering the blood supply, it impacts the uterus and lactation. However, when it is released into specific areas of the brain, it can affect cognitive, emotional, and social behaviors.

According to one review of research into oxytocin, the impact of the hormone on “pro-social behaviors” and emotional responses is a contributing factor to trust, relaxation, and psychological stability.

Brain oxytocin also seems to reduce stress responses, such as anxiety. These effects have been observed in various species. The hormone has been referred to as a vital element of a complex neurochemical system that enables the body to adapt to highly emotive circumstances.

Behavioral Effects

Researchers have been able to observe the effect of oxytocin on behavior by delivering it through a nasal spray.

Research published in 2011 in Psychopharmacology found that intranasal oxytocin enhanced self-perception in social settings and increased qualities such as trust, warmth, openness, and altruism in an individual.

A 2013 study published in PNAS indicated that oxytocin might help men to remain faithful to their partners by activating the brain’s reward centers.

In a study published in the journal Emotion in 2014, researchers suggested that individuals saw facial expressions of emotions in others more acutely after receiving oxytocin through a nasal spray.

Psychiatric Therapy

Oxytocin has been proposed as a possible treatment of autism, social phobia, as well as postpartum depression.

Scientists have indicated that it might help enhance individual and interpersonal wellbeing and that it may be useful for people with certain neuropsychiatric conditions.

They believe that it could be helpful for individuals who are avoidant of social interactions as well as those who experience persistent fear and an inability to be trusting towards others.

Oxytocin may also be useful in anger management. Research indicates that some polymorphisms of the oxytocin receptor (OXTR) gene are linked to an enhanced tendency to react angrily to situations.

AIP provides advanced compounding pharmacy solutions, including online prescription refills to patients in Long Beach, Torrance, Los Angeles, South Bay Orange County, Southern California areas, and online nationwide.

For more information on compound pharmacy medications available or to make an online prescription purchase, please or call Toll Free 1-855-247-7948.

American Integrative Pharmacy is located in Lomita, CA serving residents in and around Orange County, Los Angeles, Long Beach, Torrance and surrounding areas. Online prescription sales are available across the US.

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  • Oxytocin (Love Hormone)

    Oxytocin Chemical Bond Structure

    What is Oxytocin

    Oxytocin, which is famously known as the ‘love hormone’ or the ‘trust hormone’ is an endogenous hormone that is naturally secreted by the supraoptic and the paraventricular nucleus of the hypothalamus. After its secretion, it is stored in the posterior pituitary glands. This so-called “love hormone” plays a very important role in childbirth, pregnancy, lactation, emotional bonding and social relations. Oxytocin works on pregnant women by stimulating the contraction of the smooth muscles in the uterus which is usually an indication that it is the end of the pregnancy and the beginning of childbirth. After the child delivery, oxytocin stimulates the production of a mother’s milk by activating the alveoli and enabling milk let-down which facilitates the whole process of lactation. There are speculations that in addition to these two processes, oxytocin also improves and strengthens the emotional bonds between a mother and her child. This hormone has been linked to mating and some parenting characteristics. Oxytocin is naturally produced in the body during sexual interactions and sexual intercourse in both men and women and for this reason, it is believed that this hormone is related to sexual and emotional bonding between two people. Numerous controlled studies have been carried out on the effects of this hormone on mental conditions like autism and its role or relationship in the developmental impairment of the brain that is associated with this condition.

    Oxytocin has been around for a relatively long time, but they have never proved to be more effective when compared to the nasal spray form of this hormone. Injection products of this hormone have also been used, in fact, for the longest time but they have never made a breakthrough in the clinical markets maybe because self-injections have always been perceived as painful and very risky. Ever since the Oxytocin nasal sprays were introduced, many other products have followed suit but none of them have been adopted or preferred like the nasal spray forms. The nasal sprays of Oxytocin have been widely prescribed by physicians and used by patients not only because they are safe, simple and easy to use, but also because their effect can last for a whole day, which is far much longer than a single injection can. Nasal spray forms of Oxytocin also allow the hormone to travel actively and directly from the blood stream into the brain, which further assures its reliability.

    Oxytocin can be clinically used to induce labor, to strengthen uterine contractions and to control post-partum bleeding in maternal women. In the United States, the use of oxytocin for managing clinical conditions was approved by the Federation of Drugs Association in 1962. However, intranasal formulations that can be used to activate milk let down are no longer manufactured.

    The Mechanism of Action of Oxytocin

    The synthetic form of Oxytocin showcases the same pharmacological characteristics as the endogenously produced oxytocin. These responses are determined by dilation, cervical parity, and the duration of labor in cases of labor stimulation. Oxytocin increases the permeability of the uterine myofibrils to sodium which indirectly stimulates the contraction of the smooth muscles of the uterus. Labour responses are very crucial to childbirth and child delivery so the uterus responds more actively and readily to Oxytocin in the presence of very high concentrations of estrogen and with an increasing duration of pregnancy. The levels of Oxytocin in pregnant women increases gradually for about 20 to 30 weeks into the pregnancy, then it goes through a plateau phase after 34 weeks until the end of the pregnancy when the woman’s sensitivity to oxytocin sharply increases. Women in labor are very sensitive to oxytocin when compared to women who are pregnant but not in labor and this is a very big advantage because it solicits uterine contractions. Oxytocin increases the frequency and the amplitude of uterine contractions which consequently inhibits the flow of blood to the uterus and leads to a decrease in cervical activities which causes dilation and effacement of the crevice thus facilitating the whole process of childbirth and child delivery.

    Oxytocin Structure

    As for lactation, oxytocin leads to the contraction of the myoepithelial cells that surround the alveolar ducts of the breast. This action induces milk let-down from the alveolar channels into the larger breast sinuses which in turn facilitates the ejection of milk from the breasts. Oxytocin has no galactopoietic properties but when it is not present, the milk ejection reflex and the production of milk fails.
    Oxytocin often leads to the dilation of the vascular smooth muscles which subsequently increases the flow of blood through the renal artery, cerebral arteries, and the coronary arteries. This action does not affect the pressure of blood in the body, but with the administration of very high doses or higher concentrations in solutions, the body’s blood pressure can be slightly decreased. This slight fall in the body’s blood pressure can lead to a reflex tachycardia or a slight increase in blood pressure which will ultimately be followed by another decrease in blood pressure.
    Various studies that have been conducted on oxytocin have demonstrated some antidiuretic effects of this hormone but these effects are very minimal. However, if this hormone is administered concurrently with an excessive volume of an electrolyte free sodium solution at a rapid rate, its antidiuretic effects can be magnified. This process can result in severe water poisoning so it should be avoided completely.
    Men generally produce lower levels of oxytocin when compared to women. Studies done on men in monogamous relationships have shown that this hormone can contribute to loyalty and fidelity by enhancing the female partner’s attractiveness when compared to other women. It has not been clearly established how this hormone works to achieve this but more research is being conducted. Researchers have very many theories on the effects of oxytocin on the human social behavior. Particularly, scientists argue that most hormones do not have the ability to influence behavior directly, instead, they affect the way human beings think. In the case of Oxytocin, there are suggestions that its anxiolytic properties are responsible for reducing anxiety which in turn prompts human beings to get close and stay close to a special someone. Oxytocin allows the brain to pay more attention to subtle cues and it also enables the brain to analyze social information at a higher capacity than during normal situations.

    The Pharmacokinetics of Oxytocin

    Oxytocin can be administered through a nasal inhalation and a parenteral injection. After a parenteral injection, this hormone attains steady levels in the plasma in about 40 minutes and it has a half-life of around 1-6 minutes. In pregnant women, this drug is usually distributed throughout the extracellular fluid with minimal amounts being passed on to the fetus. Oxytocinase is one of the few glycoprotein-amino peptides that has the ability to degrade oxytocin. It is usually produced at the onset of pregnancy then its levels are standardized and maintained in the plasma. The activity of this enzyme increases gradually until the time of birth when there is a sharp increase in Oxytocin. It is then metabolized when the effects of Oxytocin are desired in the uterus, the plasma, and the placenta. After child delivery, the activities of this enzyme gradually decline until it is excreted from the system. Oxytocinase most probably originates from the uterus and its main function is to check and regulate the amount of oxytocin in the uterus of pregnant women. There is very little to no degeneration of oxytocin in men and women who are not pregnant. Oxytocin undergoes metabolisis in the lactating mammary glands and it can be distributed into breast milk. After its metabolisis, it is rapidly removed from the plasma through the kidneys and the liver, a very small amount of this hormone is excreted through the urine.

    Route-specific Pharmacokinetics of Oxytocin

    Oral route administration. Chymotrypsin, which is always present in the GI tract immediately destroys oxytocin on interaction which renders any oral administration ineffective, oxytocin is therefore never administered orally.
    Intravenous administration. When oxytocin is administered through an intravenous infusion, it solicits its effects on a woman’s uterine walls almost immediately and these effects can subside in about an hour, so this method is usually preferred when managing conditions that require fast and emergency responses.

    Intramuscular route administration. When oxytocin is administered through an intramuscular injection, the uterus can respond in about three to five minutes. And this response will subside in about 2-3 hours.

    Topical Route/ intranasal administration. Intranasal administration offers the most effective way of this medication’s administration because it is directly absorbed into the body and its effects last for longer than when using the other methods. After an intranasal administration, the myoepithelial tissues surrounding the breasts in women rapidly contract and these effects can be experienced within minutes. That is why intranasal administrations are the most preferred as a method of inducing lactation in mothers after a child delivery.

    Indications of Oxytocin

    The latest studies on the effects of oxytocin on the brain have revealed that this hormone plays major roles in the body that are far beyond that of childbirth and lactation only. Oxytocin also plays a key role in the establishment of social behaviors and personal relationships. Oxytocin also affects the feelings of love, trust and caring. Due to its positive influences on socialization, oxytocin has been indicated for the management of various mental disorders that can include autism, social anxiety, and schizophrenia. Smaller-scale studies have established that sniffing this hormone can help people with a condition of autism to interpret and understand social cues at a more advanced level and at a higher capacity. Because of these effects, many physicians prescribe it for the management of mental disorders in children.

    In men, oxytocin is primarily indicated for the treatment of delayed orgasms and it is used to induce post orgasmic penile detumescence. In women, it is used to induce milk let-down which facilitates breastfeeding of infants and it can also be used to intensify sexual arousals. Oxytocin can be used in a case of prolonged pregnancy or during an abortion because of its labor inducing action.

    Contraindications and Precautions of Oxytocin

    Endogenous oxytocin is always involved in the process of lactation and it is always used as a treatment solution in mothers who experience difficulties with breastfeeding and those who cannot naturally induce the process of milk let down after child delivery. It can be excreted through the breast milk but it is not expected to have any effects on a breastfeeding infant.
    Parenteral administration of oxytocin should be conducted by a qualified physician and it should be executed in a setting that has adequate and intensive medical care equipment and surgical facilities. These should be readily available in case of any adverse reactions because negative reactions from this administration can be life threatening.
    According to manufacturers, synthetic oxytocin should only be used when the induction of labor is unavoidably necessary and this should be for medical purposes only. Oxytocin should never be used for a selective induction of labor since there is very little evidence to clearly establish the risk-benefit ratio of this process. During the administration of oxytocin, the fetuses and the mother’s heart rates, uterine contractions, and the mother’s blood pressure should be monitored. Where possible, the mother’s inter-uterine pressure should also be monitored so that any negative effects can be avoided before they lead to tragic results and future complications. If any kind of hypersensitive reaction occurs, the administration of this medication should be discontinued immediately. Uterine contractions that are induced by Oxytocin will decrease steadily after the administration is discontinued.
    Inducing labour using oxytocin should be avoided whenever there is any evidence of the following conditions: abnormal foetal bleeding, fetal distress, fetal prematurity, uterine prolapse, placental Previa, caphalopelvic disproportion, Vasa Previa, grand multiparity, cervical cancer, genital herpes, previous surgery of the uterus or cervix which includes more than two caesarian deliveries and any other condition that may prevent an obstetric emergency that may require a surgical operation. Using Oxytocin in any of these situations might pose a risk that may lead to unnecessary maternal and fetal distress.
    Clinical studies on oxytocin have established that this hormone may possess some antidiuretic effects and using it for prolonged periods of time can increase its chances of showcasing its antidiuretic effect. Using oxytocin for extended periods of time or the administration of oxytocin in very large volumes with low sodium infusion fluids is strongly contraindicated especially in patients with a condition of eclampsia or patients with uterine atony. This is because the antidiuretic effects of oxytocin can lead to potential water intoxication because of hypertension which can result in very adverse effects on the body.

    Interactions of Oxytocin

    In a number of selected cases, oxytocin can be used in combination with other oxytocics for the sake of clinical purposes. It should, however, be noted that there is a very high risk of severe uterine hypertrophy with a possible cervical laceration or a uterine rupture.
    The concurrent use of prostaglandin E2, dinoprostone and oxytocin is not considered safe, so it is highly contraindicated. After removing a vaginal dinoprostone insert, it is advisable that you avoid using any other oxytocic agent for a period of at least 30 minutes. Oxytocic products should be used sequentially and with strict supervision from a qualified medical care provider.

    The concurrent use of oxytocin with general anesthetics or with epidural and other spinal anesthetics can lead to the development of adverse cardiovascular conditions especially in individuals with a history of pre-existing heart conditions. The administration of cyclopropane with or without oxytocin has revealed various negative implications that can include maternal sinus bradycardia, hypotension, increase in cardiac output and heart rates, abnormal atrioventricular rhythms and systemic venous returns, in addition, the administration of halothane can decrease the sensitivity and responsiveness of the uterus to oxytocin and in very high doses, it can render this hormone ineffective. This can greatly increase an individual’s risk of uterine bleeding. It has not been clearly established whether other halogenated anesthetics will react to oxytocin in this manner but more studies are being conducted in order to confirm their effects and come to solid conclusions.

    The concurrent administration of prophylactic vasopressors with oxytocin can lead to severe and persistent hypertension, these two drugs exhibit a synergistic vaso-constrictive effect on blood vessels. So this should be totally avoided. The incidence and effects of such an interaction can be decreased if vasopressors are not administered prior to any oxytocin medications. This interaction can also include other sympathomimetics like ephedra and mahuang.
    You should avoid any oxytocin medication if you are undergoing treatment using any of the following medications; All medicines used to manage blood pressure, all medicines used to induce sleep during surgery and any other medications that are used to contract the uterus.
    This list does not describe all the possible interactions so you should remember to always provide your health service provider with a list of all the medications that you are currently on, this should include all herbs and non-herbs, dietary supplements, vitamins, drugs such as alcohol and cigarettes and any other illegal drugs.

    Side Effects of Oxytocin

    Some individuals can experience hypersensitive reactions to the effects of Oxytocin. These side effects can also be realized after the administration of excessive doses of this medication which can lead to increased hypertonic uterine contractions that can last for very long periods of time. This can result in a number of reactions that can include; excessive postpartum bleeding, cervical laceration, pelvic hematoma and rupturing of the uterus.

    Some cardiovascular effects that can be experienced by maternal women include hypertension, premature ventricular contractions, and arrhythmia exacerbation. Effects on the fetus can include; PVC’s, bradycardia and other forms of arrhythmias.
    Due to its antidiuretic effects, severe water intoxication can occur if oxytocin is administered in very high doses of about 40 – 50 milliunits per minute and for extended periods of time. The management of water intoxication can include supportive therapy or an immediate oxytocin cessation. Very large doses of oxytocin can lead to fetal death, permanent brain damage of the fetus or a permanent damage of its central nervous system. Other rare complications like bleeding of the conjunctiva, blurred vision, and pulmonary edema have also been associated with water intoxication that is as a result of oxytocin. The administration of oxytocin has also been associated with anaphylactoid reactions.

    Oxytocin-induced labor has implications of increased incidences of neonatal hyperbilirubinemia which is about 1.6 times more likely to occur than under normal circumstances. This can lead to a condition of neonatal jaundice.
    Nausea and vomiting are also some side effects that have been associated with oxytocin.
    You should contact your health service provider or seek emergency healthcare services immediately in case you experience any negative reactions after the administration of this medicine.
    Some individuals can experience allergic reactions like skin rashes, itching, hives, swelling of the tongue face or lips and irritation. Other side effects can include breathing problems, excessive or continuous vaginal bleeding and an unusual weight gain.

    Side effects like headaches and vomiting are very common and they don’t usually require serious medical attention except when they persist to disturbing levels.

    This list may not include all the possible side effects and adverse reactions but if you ever experience any signs of a negative reaction, you should contact your health care service provider immediately.
    If you miss a dose, you should take it as soon as you remember about it. Store all your medicine in a cool dry place away from sunlight and away from the reach of children.

    Conclusion

    Oxytocin is commonly prescribed for the treatment of sexual arousal issues, delayed orgasms in men and post-orgasmic penile detumescence. The strength combination of this hormone available in our pharmacy is 50 IU/ml in a 10ml spray activator. All our solutions are compounded under strict guidelines of the USP 795 which efficiently assures their quality. We have a standard quality assurance process which further ensures that all the products we dispense are uniform, consistent and potent. For more information about this medication and its administration, feel free to contact us.

    Oxytocin

    Generic Name: Oxytocin (oks i TOE sin)
    Brand Name: Pitocin

    Medically reviewed by Drugs.com. Last updated on Sep 1, 2019.

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    Warning

    • Do not use oxytocin to start the labor unless needed for medical reasons. Talk with your doctor.

    Uses of Oxytocin:

    • It is used to start labor.
    • It is used to stop or treat bleeding that happens after a birth or an abortion.
    • It is used to end a pregnancy.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take Oxytocin?

    • If you have an allergy to oxytocin or any other part of oxytocin.
    • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

    This medicine may interact with other drugs or health problems.

    Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take oxytocin with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

    What are some things I need to know or do while I take Oxytocin?

    • Tell all of your health care providers that you take oxytocin. This includes your doctors, nurses, pharmacists, and dentists.
    • Very bad and sometimes deadly effects like high blood pressure, bleeding in the brain, rupture of the uterus, too much water in the body, and deaths of the unborn baby from many causes have happened with oxytocin. Talk with your doctor.
    • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using oxytocin while you are pregnant.
    • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

    How is this medicine (Oxytocin) best taken?

    Use oxytocin as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    • It is given as a shot into a muscle.
    • It is given as an infusion into a vein over a period of time.

    What are some side effects that I need to call my doctor about right away?

    WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
    • Bleeding a lot (soaking 1 pad per hour).
    • Slow heartbeat.
    • A heartbeat that does not feel normal.
    • Trouble passing urine.
    • Very bad belly pain.
    • Seizures.
    • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.

    What are some other side effects of Oxytocin?

    All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

    • Upset stomach or throwing up.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

    You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

    If OVERDOSE is suspected:

    If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

    How do I store and/or throw out Oxytocin?

    • If you need to store oxytocin at home, talk with your doctor, nurse, or pharmacist about how to store it.

    Consumer information use

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else’s drugs.
    • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
    • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
    • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about oxytocin, please talk with your doctor, nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

    Further information

    Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

    Medical Disclaimer

    More about oxytocin

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    Consumer resources

    • Oxytocin
    • Oxytocin Intravenous, Intramuscular (Advanced Reading)

    Other brands: Pitocin

    Professional resources

    • Oxytocin (AHFS Monograph)
    • … +2 more

    Related treatment guides

    • Abortion
    • Labor Induction
    • Postpartum Bleeding

    Intro

    (Image credit: Dreamstime)

    Oxytocin the so-called “love hormone” is being increasingly shown to trigger a wide variety of physical and psychological effects in both women and men.

    The hormone’s influence on our behavior and physiology originates in the brain, where it’s produced by the by a structure called the hypothalamus, and then transfers to the pituitary gland which releases into the bloodstream.. Like antennas picking up a signal, oxytocin receptors are found on cells throughout the body. Levels of the hormone tend to be higher during both stressful and socially bonding experiences, according to the American Psychological Association.

    “It’s like a hormone of attachment, you might say,” said Carol Rinkleib Ellison, a clinical psychologist in private practice in Loomis, California and former assistant clinical psychiatry professor at the University of California, San Francisco. “It creates feelings of calm and closeness.”

    Thought scientists have long known about oxytocin’s rolein breastfeeding and childbirth, “We’re just learning more about it now,” Ellison said.

    A stream of studies in the last decade have focused on oxytocin’s effects on body and mind. Here’s a look at what we’ve learned.

    Oxytocin promotes attachment

    (Image credit: Stephen Eastop | Stock Xchng)

    Pregnant women with higher levels of oxytocin during their first trimester bonded more strongly with their babies after they were born, according to a 2007 study in the journal Psychological Science. And compared with other women, women with higher levels throughout their pregnancy and in the first month after birth reported engaging in more behaviors such as singing, feeding and bathing their infants in specific ways that promoted an exclusive relationship between the two, the study found.

    Oxytocin solidifies relationships

    (Image credit: Hector Landaeta | Stock Xchng)

    Comparing urine levels of oxytocin and a related hormone called vasopressin in biological and adoptive children who lived in Russian and Romanian orphanages, researchers found that oxytocin rose in biological children after having contact with their mothers. The study, published in 2005 in the journal Proceedings of the National Academy of Sciences, showed that oxytocin levels remained static in the adoptive children in the same situation, suggesting a physiological basis for why some adoptive children have difficulty forming secure relationships.

    Oxytocin eases stress

    (Image credit: Bob Smith | Stock Xchng)

    Research done on prairie voles showed that those separated from their siblings exhibited signs of anxiety, stress and depression that abated after they were injected with oxytocin. The study, presented at a 2007 meeting of the Society for Neuroscience, indicated the hormone’s effects were more evident under stressful situations.

    Oxytocin crystallizes emotional memories

    (Image credit: Julia Freeman-Woolpert | Stock Xchng)

    A November study in the journal Proceedings of the National Academy of Sciences supported researchers’ theory that oxytocin would amplify men’s early memories of their mothers. In a group of 31 men, those who inhaled a synthetic version of the hormone found the hormone intensified fond memories of their mothers if their relationships had been positive. Those whose ties with their mom’s had frayed downgraded their opinions after inhaling oxytocin, the study showed.

    Oxytocin facilitates childbirth and breastfeeding

    (Image credit: Allison Cooper | Stock Xchng)

    In its best understood role, oxytocin is released in large amounts during labor, intensifying the uterine contractions that open the cervix and allow the baby to pass through the birth canal. Physicians have been using synthetic oxytocin, also known by its brand name Pitocin, to induce or augment labor since the early 1900s. After birth, the hormone continues to stimulate uterine contractions that discourage hemorrhaging, and more is released when the nipples are stimulated during suckling, promoting the letdown of milk into the nipples.

    Oxytocin boosts sexual arousal

    (Image credit: Jonathan Fain | Stock Xchng)

    Spontaneous erections in rats were observed after oxytocin was injected into their cerebrospinal fluid in a 2001 study in the journal Physiological Review. And a cocktail of brain chemicals that includes oxytocin is released in men during ejaculation. These chemicals can intensify bonding between sexual partners , though, Ellison noted, “it isn’t the same for everyone.”

    “I think there is a variability,” said Ellison, who also teaches sexuality classes to health professionals. “For people who can really get into the sensualness of hugging and cuddling, that is the hormone released in this process. For people who don’t get into it, maybe they’re not releasing the oxytocin. It may be a circular thing.”

    Oxytocin reduces drug cravings

    (Image credit: Vangelis Thomaidis | Stock Xchng)

    According to a 1999 article in the journal Progress in Brain Research, some studies indicate that oxytocin inhibits tolerance to addictive drugs, including opiates, cocaine and alcohol , and reduces withdrawal symptoms. “It’s an antidote to craving,” Ellison explained. “That craving (for drugs), that hunger, is probably eased with this hormone. It’s involved with the satisfaction of hunger.”

    Oxytocin improves social skills

    (Image credit: Sanja Gjenero | Stock Xchng)

    A February study in the journal Proceedings of the National Academy of Sciences showed that inhaling oxytocin significantly improved the ability of people with autism to interact with others. Previous studies indicated natural oxytocin levels were lower in those with autism, a developmental disorder characterized by difficulties in communication and social relationships. Oxytocin also reduced autistic individuals’ fear of others, researchers said.

    Oxytocin triggers protective instincts

    (Image credit: Elvis Santana | Stock Xchng)

    A June study in the journal Science suggested oxytocin triggers defensive aggression against outsiders who might threaten someone’s social group, such as in soldiers who defend their comrades. Prior animal studies had shown that the hormone promotes protectionist behavior, but this research was the first to demonstrate a similar effect in humans.

    Oxytocin induces sleep

    (Image credit: stock.xchng)

    Oxytocin released in the brain under stress-free conditions naturally promotes sleep , according to a 2003 study in the journal Regulatory Peptides. Ellison said this link makes sense because oxytocin counters the effects of cortisol, which is the known as the stress hormone. “It has a calming effect,” she said. “It leaves you feeling tranquil and loving, and certainly that helps our path to sleep.”

    Oxytocin Nasal Spray Improves Self-Control in Overweight Men

    A single dose of oxytocin nasal spray, known to reduce food intake, decreases impulsive behavior in overweight and obese men, according to a preliminary study to be presented Saturday at the Endocrine Society’s 98th annual meeting in Boston.

    Oxytocin nasal spray (made by Novartis) is a synthetic version of the hormone oxytocin, which is important for controlling food intake and weight. It is approved in Europe but not in the United States other than in clinical trials. Oxytocin is available in the United States as an intravenous or injectable drug (Pitocin) to induce labor.

    Researchers from Massachusetts General Hospital reported last year that oxytocin nasal spray reduced intake of calories and fat at a test meal without affecting appetite, but they were not sure how the drug has that affect. Results of their new pilot study in 10 overweight and obese men suggest that one way oxytocin lowers food intake might be by improving self-control, said co-investigator Franziska Plessow, PhD, an instructor in medicine at Harvard Medical School and a research fellow in the Neuroendocrine Unit at Massachusetts General Hospital, Boston.

    “Knowing the mechanisms of action of intranasal oxytocin is important to investigating oxytocin as a novel treatment strategy for obesity,” Plessow said. “This information may allow us to move forward to large clinical trials, identify who can benefit from the drug, and help optimize the treatment.”

    To demonstrate the study subjects’ ability to suppress impulsive behavior, the investigators administered a psychology research test called the stop-signal task. In this test, the subject sat in front of a computer and became trained to respond to a square symbol on the computer screen by pressing a designated left button on the keyboard and to a triangle by pressing a right button. After the subject became familiar with that task, he was told to not press a button when he saw a symbol but heard a beep (the stop signal). Because the beep occurred after the symbols appeared with a varying delay that was adjusted to each subject, the new task required the subject to control the behavioral impulse to respond, Plessow explained.

    Participants took the test on two occasions 15 minutes after they self-administered a dose of nasal spray in each nostril. In a randomly assigned order, one day they received oxytocin and another they received a placebo, or dummy drug. Neither participants nor the tester knew which treatment they received. The men ranged in age from 23 to 43 years and were overweight or obese (BMI ranging from 27.7-33.9 kg/m2).

    The study, which received pilot grants from the National Institutes of Health-funded Boston Nutrition Obesity Research Center and Nutrition Obesity Research Center at Harvard, had exciting results, according to Plessow. After receiving oxytocin, participants less frequently pressed the button when they were not supposed to. This demonstrated that they were acting less impulsively and exerting more control over their behavior after receiving oxytocin, she said.

    Plessow said more study is necessary to determine how oxytocin alters self-control and how important this mechanism is in regulating food intake since not all overeating relates to poor self-control. They also will need to test the drug in women.

    “Our preliminary results in men are promising,” she said. “Oxytocin nasal spray showed no strong side effects and is not as invasive as obesity surgery.”

    ‘Love hormone’ oxytocin nasal spray could help treat alcoholism, study finds

    Scientists believe an oxytocin nasal spray could help treat alcoholism, according to a new study.

    The research, published in the journal PLOS Biology on Tuesday, found that alcohol-dependent rats drank less after they were given a dose of oxytocin, the “cuddle hormone.”

    The authors of the study — led by Drs. Tunstall, Koob and Vendruscolo of the National Institutes of Health and Drs. Kirson and Roberto of The Scripps Research Institute — believe their findings could translate into new pharmaceutical treatments for alcoholism, a release said.

    Oxytocin, sometimes known as the “cuddle hormone” or the “love hormone,” is released when people bond or hug, according to Medical News Today.

    The hormone has already been found to have “promise” as a possible treatment for drug abuse because it decreases withdrawal symptoms and drug-seeking behavior for several narcotics, according to the release.

    Researchers decided to test how oxytocin might reduce alcohol consumption by giving doses of oxytocin through the nose (intranasally) and through the abdomen (intraperitoneally) to alcohol-dependent rats and normal rats, according to the study’s abstract.

    Though both forms of oxytocin blocked increased alcohol drinking in alcohol-dependent rats, the hormone given through the abdomen reduced movement in the rats, while oxytocin given to rats through their nose did not.

    The scientists also looked at how the oxytocin affected alcohol consumption and altered signaling of the neurotransmitter GABA, which is located in a brain region highly affected by alcohol dependence, the central nucleus of the amygdala (CeA).

    “The experiments demonstrated that oxytocin administered systemically, intranasally or into the brain blocked excess drinking in alcohol-dependent but not in normal rats,” the statement said. “Moreover, oxytocin blocked GABA signaling in the CeA.”

    “Taken together, these results provide evidence that oxytocin likely blocks enhanced drinking by altering CeA GABA transmission,” the statement continued.

    Scientists believe an oxytocin nasal spray could help treat alcoholism, according to a new study.

    The research, published in the journal PLOS Biology on Tuesday, found that alcohol-dependent rats drank less after they were given a dose of oxytocin, the “cuddle hormone.”

    The authors of the study — led by Drs. Tunstall, Koob and Vendruscolo of the National Institutes of Health and Drs. Kirson and Roberto of The Scripps Research Institute — believe their findings could translate into new pharmaceutical treatments for alcoholism, a release said.

    SCIENTISTS ‘REVERSE’ ALCOHOLISM IN RATS BY SHOOTING LASERS AT PART OF THEIR BRAINS

    Oxytocin, sometimes known as the “cuddle hormone” or the “love hormone,” is released when people bond or hug, according to Medical News Today.

    The hormone has already been found to have “promise” as a possible treatment for drug abuse because it decreases withdrawal symptoms and drug-seeking behavior for several narcotics, according to the release.

    A new study has found that an oxytocin nasal spray could help treat alcoholism, after researchers found the “love hormone” helped block increased drinking in alcohol-dependent rats. (iStock)

    Researchers decided to test how oxytocin might reduce alcohol consumption by giving doses of oxytocin through the nose (intranasally) and through the abdomen (intraperitoneally) to alcohol-dependent rats and normal rats, according to the study’s abstract.

    GOV. CUOMO’S PROPOSED PRESCRIPTION OPIOID SURCHARGE UNDER FIRE, CRITICS CALL IT TAX ON PAIN

    Though both forms of oxytocin blocked increased alcohol drinking in alcohol-dependent rats, the hormone given through the abdomen reduced movement in the rats, while oxytocin given to rats through their nose did not.

    The scientists also looked at how the oxytocin affected alcohol consumption and altered signaling of the neurotransmitter GABA, which is located in a brain region highly affected by alcohol dependence, the central nucleus of the amygdala (CeA).

    “The experiments demonstrated that oxytocin administered systemically, intranasally or into the brain blocked excess drinking in alcohol-dependent but not in normal rats,” the statement said. “Moreover, oxytocin blocked GABA signaling in the CeA.”

    “Taken together, these results provide evidence that oxytocin likely blocks enhanced drinking by altering CeA GABA transmission,” the statement continued.

    OXYTOCIN NASAL SPRAY

    General Information: Endogenous oxytocin is a hormone secreted by the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior pituitary. It stimulates contraction of uterine smooth muscle during gestation and causes milk ejection after milk has been produced in the breast. Oxytocin has been associated with mating, parental, and social behaviors. Oxytocin is released during intercourse in both men and women, which has led to the belief that it is involved in sexual bonding. There is speculation that in addition to facilitating lactation and the birthing process, the hormone facilitates the emotional bond between mother and child.1 Oxytocin has also been studied in autism and have some sort of relation to the social and developmental impairments associated with the disease.2 Clinically, oxytocin is used most often to induce and strengthen labor and control postpartum bleeding. Intranasal preparations of oxytocin, used to stimulate postpartum milk ejection, are no longer manufactured in the U.S. Oxytocin was approved by the FDA in 1962.

    Mechanism of Action: Synthetic oxytocin elicits the same pharmacological response produced by endogenous oxytocin, with cervical dilation, parity, and gestational age as predictors of the dose response to oxytocin administration for labor stimulation.3 Oxytocin increases the sodium permeability of uterine myofibrils, indirectly stimulating contraction of the uterine smooth muscle. The uterus responds to oxytocin more readily in the presence of high estrogen concentrations and with the increased duration of pregnancy. There is a gradual increase in uterine response to oxytocin for 20 to 30 weeks gestation, followed by a plateau from 34 weeks of gestation until term, when sensitivity increases.3 Women who are in labor have a greater response to oxytocin compared to women who are not in labor; only very large doses will elicit contractions in early pregnancy. In the term uterus, contractions produced by exogenous oxytocin are similar to those that would occur during spontaneous labor. Oxytocin increases the amplitude and frequency of uterine contractions, which transiently impede uterine blood flow and decrease cervical activity, causing dilation and effacement of the cervix.

    Oxytocin causes contraction of the myoepithelial cells surrounding the alveolar ducts of the of the breast. This forces milk from the alveolar channels into the larger sinuses, and thus facilitates milk ejection. While oxytocin possesses no galactopoietic properties, if it is absent the milk-ejection reflex in the breast fails.

    Oxytocin causes dilation of vascular smooth muscle, thus increasing renal, coronary, and cerebral blood flow. Blood pressure usually remains unaffected, but with the administration of very large doses or high concentration solutions blood pressure may decrease transiently. This transient decrease in blood pressure leads to reflex tachycardia and an increase in cardiac output; any fall in blood pressure is usually followed by a small, but sustained, increase in blood pressure.

    Oxytocin does possess antidiuretic effects, but they are minimal. If oxytocin is administered with an excessive volume of electrolyte-free IV solution and/or at too rapid a rate, the antidiuretic effects are more apparent and water intoxication can result.

    Pharmacokinetics: Oxytocin administered effectively by parenteral injection or nasal inhalation. Steady state, following parenteral administration, is usually achieved in plasma by 40 minutes.3 Oxytocin’s plasma half-life is between 1 and 6 minutes. The drug distributes throughout the extracellular fluid, with minimal amounts reaching the fetus.

    Oxytocinase, a glycoprotein aminopeptidase that is capable of degrading oxytocin, is produced during pregnancy and is present in the plasma. Enzyme activity increases gradually until term approaches, when there is a sharp rise in plasma levels and activity is high in the plasma, placenta and uterus. After delivery enzyme activity declines. Oxytocinase most likely originates from the placenta and regulates the amount of oxytocin in the uterus; there is little or no degradation of oxytocin in men, nonpregnant women, or cord blood. Oxytocin is rapidly removed from plasma by the liver and the kidneys, with only small amounts being excreted unchanged in the urine. Oxytocin is metabolized in the lactating mammary gland and is distributed into breast-milk.

    Route-Specific Pharmacokinetics:

    Topical Route: Following intranasal use of oxytocin, contractions of the myoepithelial tissue surrounding the alveoli of the breasts begin within minutes and persist for about 20 minutes.

    Indications: Oxytocin is indicated in the treatment of delayed orgasm and inducing post-orgasmic penile detumescence in men, inducing milk letdown to foster breastfeeding in women, intensifying sexual arousal, and in the treatment of autism.

    Contraindications and Precautions: Oxytocin is indicated during pregnancy to induce labor; it precipitates uterine contractions and abortion.3

    Endogenous oxytocin is involved in the process of lactation and therefore, oxytocin has been used in mothers having difficulty with engorgement and breast-feeding. Because several small studies have failed to show a beneficial effect, oxytocin is not used for this indication. Oxytocin is excreted in the breast-milk, but is not expected to have adverse effects in the infant.4

    Parenteral oxytocin should be used only by qualified professional personnel in a setting where intensive care and surgical facilities are immediately available. Furthermore, according to the manufacturer, oxytocin should only be used when induction of labor is necessary for medical reasons. It should not be used for elective induction of labor as available data are insufficient to evaluate the risk-benefit ratio in this indication. During oxytocin administration, uterine contractions, fetal and maternal heart rate, maternal blood pressure, and, if possible, intrauterine pressure should be continuously monitored to avoid complications. If uterine hyperactivity occurs, oxytocin administration should be immediately discontinued; oxytocin-induced stimulation of the uterine contractions usually decreases soon after discontinuance of the drug. The induction or continuance of labor with oxytocin should be avoided when the following conditions or situations are present: evidence of fetal distress, fetal prematurity, abnormal fetal position (including unengaged head), placenta previa, uterine prolapse, vasa previa, cephalopelvic disproportion, cervical cancer, grand multiparity, previous surgery of the uterus or cervix (including 2 or more cesarean deliveries), active genital herpes infection, or in any condition presenting as an obstetric emergency requiring surgical intervention. Use of oxytocin in any of these settings can aggravate the condition or cause unnecessary fetal or maternal distress.

    Oxytocin may possess antidiuretic effects, and prolonged use can increase the possibility of an antidiuretic effect. Prolonged use of oxytocin and administration in large volumes of low-sodium infusion fluids are not recommended, particularly in patients with eclampsia or who have unresponsive uterine atony. Antidiuretic effects have the potential to lead to water intoxication and convulsive episodes due to hypertension.

    Pregnancy: Oxytocin is indicated during pregnancy to induce labor; it precipitates uterine contractions and abortion.3

    Breast-Feeding: Endogenous oxytocin is involved in the process of lactation and therefore, oxytocin has been used in mothers having difficulty with engorgement and breast-feeding. Because several small studies have failed to show a beneficial effect, oxytocin is not used for this indication. Oxytocin is excreted in the breast-milk, but is not expected to have adverse effects in the infant.4

    Interactions: In certain cases, oxytocin can be used in combination with other oxytocics for therapeutic purposes. There is a risk, however, of severe uterine hypertony occurring, with possible uterine rupture or cervical laceration. The concurrent use of dinoprostone, prostaglandin E2 and oxytocin is considered contraindicated; following the removal of the dinoprostone vaginal insert, an interval of at least 30 minutes is recommended prior to the use of another oxytocic agent. These products should be used sequentially only under adequate obstetric supervision.5

    Adverse cardiovascular effects can develop as a result of concomitant administration of oxytocin with general anesthetics or with spinal or epidural anesthetics, especially in those with preexisting valvular heart disease. Cyclopropane, when administered with or without oxytocin, has been implicated in producing maternal sinus bradycardia, abnormal atrioventricular rhythms, hypotension, and increases in heart rate, cardiac output, and systemic venous return.6 In addition, halothane decreases uterine responsiveness to oxytocics (e.g., oxytocin, ergonovine, methylergonovine) and, in high doses, can abolish it, increasing the risk of uterine hemorrhage. Halothane is a potent uterine relaxant.7 It is not clear if other halogenated anesthetics would interact with oxytocics in this manner.

    The administration of prophylactic vasopressors with oxytocin can cause severe, persistent hypertension, as the 2 drugs may have a synergistic and additive vasoconstrictive effect. This interaction was noted when oxytocin was given 3—4 hours after prophylactic vasoconstrictor in conjuction with caudal anesthesia. The incidence of such an interaction may be decreased if vasopressors are not administered prior to oxytocin.6 This interaction can include certain other sympathomimetics such as ephedra, ma huang.

    Do not take this medicine with any of the following medications:
    • Ephedra, Ma Huang
    This medicine may also interact with the following medications:
    • dinoprostone, prostaglandin E2
    • medicines for blood pressure
    • medicines used for sleep during surgery
    • other medicines to contract the uterus
    This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

    Adverse Reactions: Some patients can experience a hypersensitive uterine reaction to the effects of oxytocin. Excessive doses can have the same effect. This can produce increased, hypertonic uterine contractions, possibly prolonged, resulting in a number of adverse reactions such as cervical laceration, postpartum hemorrhage, pelvic hematoma, and uterine rupture.8

    Oxytocin-induced afibrinogenemia has been reported; it results in increased postpartum bleeding and can potentially be life-threatening. Neonatal retinal hemorrhage has been reported. Also, intracranial bleeding including subarachnoid hemorrhage has been reported in patients receiving oxytocin.8 In one case, subarachnoid hemorrhage mimicked acute water intoxication and delayed the diagnosis of hemorrhage after an oxytocin assisted labor.9

    Adverse maternal cardiovascular effects from oxytocin may include arrhythmia exacerbation, premature ventricular contractions (PVCs), and hypertension. In the fetus or neonate, fetal bradycardia, PVCs, and other arrhythmias have been noted.8

    Oxytocin has an antidiuretic effect, and severe and fatal water intoxication has been noted and may occur if large doses (40—50 milliunits/minute) are infused for long periods. For example, water intoxication with seizures and coma has occurred in association with a slow oxytocin infusion over a 24-hour period. Management of water intoxication includes immediate oxytocin cessation and supportive therapy. In the fetus or neonate, fetal death, permanent CNS or brain damage, and neonatal seizures have been noted with oxytocin.8 The rare complications of blurred vision, ocular hemorrhage (of the conjunctiva), and pulmonary edema have been associated with oxytocin induced water intoxication.

    Oxytocin administration has been associated with anaphylactoid reactions.8

    Oxytocin-induced labor has been implicated in an increased incidence of neonatal hyperbilirubinemia, about 1.6 times more likely than after spontaneous labor. This can lead to neonatal jaundice.8

    Nausea and vomiting have been noted with oxytoxin.8

    Side effects that you should report to your doctor or health care professional as soon as possible:
    • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
    • breathing problems
    • excessive or continuing vaginal bleeding
    • fast, irregular heartbeat
    • feeling faint or lightheaded, falls
    • high blood pressure
    • seizures
    • unusual bleeding or bruising
    • unusual swelling, sudden weight gain
    Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
    • headache
    • nausea and vomiting.

    This list may not include all possible adverse reactions or side effects. Call your health care provider immediately if you are experiencing any signs of an allergic reaction: skin rash, itching or hives, swelling of the face, lips, or tongue, blue tint to skin, chest tightness, pain, difficulty breathing, wheezing, dizziness, red, a swollen painful area/areas on the leg.

    Storage: Store this medication in a refrigerator between 36°F to 46°F (2°C – 8°C). Do not freeze. Protect from light. Keep all medicine out of the reach of children. Throw away any medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

    • 1. Cabanac M, Pfaff DW, Ogawa S, et al. Neural oxytocinergic systems as genomic targets for hormones and as modulators of hormone-dependent behaviors. Results Probl Cell Differ 1999;26:91-105.
    • 2. Modahl C, Green L, Fein D, et al. Plasma oxytocin levels in autistic children. Biol Psychiatry 1998;43:270-277.
    • 3. American College of Obstetrics and Gynecology (ACOG). ACOG Practice Bulletin Number 10: Clinical Management Guidelines for Obstetrician-Gynecologists. Induction of labor. Washington, DC: American College of Obstetricians and Gynecologists; November 1999.
    • 4. Mangesi L, Dowswell T. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2010;9:CD006946.
    • 5. Cervidil® (dinoprostone vaginal insert) package insert. St. Louis, MO: Forest Laboratories, Inc.; 1997 Jul.
    • 6. Pitocin® (oxytocin injection, USP) package insert. Rochester, MI: Monarch Pharmaceuticals; 2003 Jan.
    • 7. Halothane, USP package insert. North Chicago, IL: Abbott Laboratories; 1998 Mar.
    • 8. Pitocin (oxytocin) package insert. Rochester, MI: JHP Pharmaceuticals, LLC; 2014 Sept.
    • 9. Curless RV, Beaumont DM, Sinar EJ, et al. Subarachnoid hemorrhage mimicking acute water intoxication during labour augmented by oxytocin infusion. Br J Clin Pract 1990;44(12):637-638.

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