Demoxytocin

Summary

Demoxytocin (1-deamino-oxytocin) is a synthetic analogue of oxytocin with enhanced stability and longer half-life. It has been used clinically for induction and augmentation of labor, control of postpartum hemorrhage, and promotion of lactation. It differs from oxytocin by deamination at the cysteine residue at position 1, conferring greater resistance to aminopeptidases. Approved and used in several European countries, often administered buccally or intranasally.

Mechanism of Action

Binds to oxytocin receptors in the myometrium and mammary gland, stimulating uterine contractions and milk ejection; acts as a full agonist at oxytocin receptors with a longer duration of action than natural oxytocin due to resistance to enzymatic degradation.

Routes of Administration

Goals & Uses

• Induction of laborObstetricsModerate
• Augmentation of laborObstetricsModerate
• Promotion of lactation / milk ejectionLactationModerate
• Third stage of labor managementObstetricsLow
• Control of postpartum hemorrhageObstetricsModerate

Contraindications

• Cephalopelvic disproportionObstetricHigh
• Placenta praeviaObstetricHigh
• Hypersensitivity to demoxytocin or oxytocinAllergyHigh
• Fetal malpresentation requiring cesareanObstetricHigh
• Hypertonic uterine contractionsObstetricHigh
• Vasa praeviaObstetricHigh

Adverse Effects

• Allergic reactionsImmunologicalRare
• Uterine hyperstimulationUterineUncommon
• HypotensionCardiovascularUncommonLow blood pressure
• Nausea and vomitingGastrointestinalCommon
• Water retention / hyponatremiaMetabolicUncommon
• Fetal bradycardiaNeonatalUncommon

Drug Interactions

• General anesthetics (e.g., halothane)Moderate
• Prostaglandins (e.g., dinoprostone, misoprostol)High
• Vasoconstrictors (sympathomimetics)Moderate
• Ergot alkaloids (e.g., ergometrine)Moderate

Population Constraints

• Grand multiparous womenObstetricRelative
• Women with cardiovascular diseaseCardiovascularRelative
• Women with prior uterine surgery or cesarean sectionObstetric HistoryRelative
• Elderly patientsAgeRelative
• Pregnant women (non-obstetric use)PregnancyAbsolute

Regulatory Status

• European UnionApprovedApproved: Induction of labor, Augmentation of labor, Postpartum hemorrhage prevention, Promotion of lactationApproved in select EU member states; availability varies by country.
• United StatesUnapprovedNot FDA-approved; oxytocin (Pitocin) is the approved oxytocin agonist in the US.
• United KingdomUnknownLimited current availability in the UK; oxytocin remains the standard agent.

Approved in several European countries (e.g., Switzerland, formerly available in others) for obstetric and lactation indications. Not FDA-approved in the United States. Marketed under brand names such as Sandopart and Syntocinon-S in some jurisdictions.

Evidence & Sources

No sources recorded yet.