Posterior pituitary hormones
ATC code: H01BB02 (Oxytocin)
Brand names
Pitocin, Syntocinon
Synthetic analog of endogenous oxytocin — a posterior pituitary peptide hormone. Binds myometrial oxytocin receptors, which markedly upregulate near term. Causes rhythmic uterine contractions identical to labor. In breast tissue, it contracts alveolar myoepithelial cells, ejecting milk. Short half-life (3–5 minutes) allows precise titration via IV infusion.
First line
First-line for labor induction and augmentation per 2009/2021 and NG207. IV via infusion pump, start 1–2 mU/min and titrate every 15–30 minutes to adequate contractions (3–5 per 10 minutes). Max 30–40 mU/min. Hospital use only with continuous fetal and maternal monitoring — hyperstimulation with fetal distress risk.
First line
First-line for prevention and treatment of uterine atony postpartum hemorrhage per 2022 and FIGO 2018. Prophylaxis: 10 IU IM or 5 IU IV immediately after birth. Treatment: 20–40 IU in 1 L saline IV drip, combined with methylergometrine, misoprostol, or carboprost as needed. Tranexamic acid is added for persistent bleeding.
Not recommended
— Oxytocin for «bonding, relationships, and autism»: Intranasal oxytocin and injections for «relationships», «bonding», «autism», or «anxiety» in popular literature and psychotherapy are not supported by international guidelines. Laboratory roles of oxytocin in social behavior have not translated into reproducible clinical effects. RCTs of oxytocin in autism (Sikich NEJM 2021) showed no benefit.
«Oxytocin for bonding and trust» — a marketed claim, not clinical.
Used exclusively during labor and for postpartum hemorrhage. Contraindicated in early pregnancy.
Compatible with breastfeeding, supports milk ejection. Intranasal forms for lactation stimulation exist but are not first-line in current guidelines.
oxytocin is evaluated for the following indications with varying evidence strength: Labor induction (evidence tier A), Postpartum hemorrhage (evidence tier A), Stress, anxiety, memory, and behavior (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of oxytocin (≥ 1 in 100): Nausea, vomiting, Maternal tachycardia, Headache, Uterine hyperstimulation. See the Safety section for uncommon and serious reactions.
Used exclusively during labor and for postpartum hemorrhage. Contraindicated in early pregnancy.
Compatible with breastfeeding, supports milk ejection. Intranasal forms for lactation stimulation exist but are not first-line in current guidelines.
oxytocin is contraindicated in: Cephalopelvic disproportion; Transverse fetal lie; Fetal distress before induction; Preeclampsia with uncontrolled severe hypertension; Uterine hypertonia. Full list in the Safety section.