Atosiban and nifedipin for the treatment of preterm labor

Abstract

Atosiban is an effective and safe drug for the acute treatment of preterm labor with minimal side effects, and it can be an option in the treatment of preterm labor, especially in patients with heart disease and multi-fetal pregnancies.

Nifedipine versus nitroglycerin for acute tocolysis in preterm labour: a randomised controlled trial

“…In the RNOTT multicentric trial, 7 however, NTG showed a lower (63%) efficacy in prolonging labour beyond 48 hours against 71% with ritodrine. Nifedipine prolonged pregnancy beyond two days in 80.9 % women compared to 69.5 % in ritodrine in a study by Papatsonis et al, 8 whereas, Kashanian et al 9 found the pregnancy prolongation beyond two days to be 75 % in nifedipine group versus 82.5 % with atosiban group. A direct comparison of NTG with nifedipine by Amorim et al 12 showed that the rate of preterm delivery within 48 hours after start of tocolysis was 15.4% in tocolysis with NTG and 12.5% in the nifedipine group.…”

“…In the trial by Papatsonis et al, 8 nifedipine was found to delay childbirth beyond 7 & 14 days in 72.1% and 64.7% patients respectively, compared to 50% and 40.7% prolongation in the ritodrine group. Kashanian et al 9 found pregnancy prolongation beyond 7 days in 65 % in nifedipine group versus 74 % in atosiban group. In the present study, nifedipine delayed delivery beyond 7 & 14 days in 72.1% and 62.8 % respectively which was not significantly different to that seen with NTG (65.9% & 58.6 % respectively).…”

“…Efforts are therefore being directed towards finding alternatives that are safer, better tolerated as well as efficacious in prolonging pregnancy, thus allowing us time for maternal administration of corticosteroids & inutero transfer of the babies to units where facilities for neonatal intensive care is available. Both nitroglycerin [4][5][6][7] and nifedipine [8][9][10][11] have been shown to be effective in preterm labour. However, only one study 12 has directly compared these two tocolytic agents.…”

Our experience of nifedipine as a tocolytic agent in preterm labor (24 weeks to 36 weeks 6 days)

“…13 Nifedipine prolonged pregnancy beyond two days in 80.9 % women and beyond 7 days in 72.1 % cases in a study by Papatsonis et al, whereas, Kashanian et al found the pregnancy prolongation beyond two days to be 75 % and beyond 7 days in 65 % women. 14,15 Nifedipine causes peripheral vasodilation causing most commonly headache (1.98%), other side effects being tachycardia, palpitation, hypotension, flushing. Dhawle et al observed headache in 4.7% cases, tachycardia was observed in 11.6 % cases.…”

A patent review of oxytocin receptor antagonists 2013-2017

“…Further development of medications to treat preterm birth resulted in the development of calcium channel blockers, namely nifedipine, which had shown an ability to delay labor onset by over 7 days. The nonselective OTR antagonist atosiban (Tractocile ™ , Ferring Pharmaceuticals) has been proven to be more effective than either activation of β-receptors or inhibiting calcium channels, producing decreased adverse side-effects with the same efficacy [8,9].…”