YUTOPAR
Clinical safety rating: caution
Comprehensive clinical and safety monograph for YUTOPAR (YUTOPAR).
Selective beta-2 adrenergic receptor agonist; relaxes uterine smooth muscle by increasing intracellular cAMP, reducing myosin light chain kinase activity and inhibiting uterine contractions.
| Metabolism | Primarily hepatic via conjugation (glucuronidation and sulfation) and CYP450 isoenzymes (CYP3A4, CYP2D6). |
| Excretion | Primarily renal (90-95% as unchanged drug and metabolites); less than 5% fecal. |
| Half-life | 1.7-2.5 hours (terminal); increased in renal impairment. |
| Protein binding | 25-30% (primarily albumin). |
| Volume of Distribution | 0.3-0.5 L/kg; distributes mainly into extracellular fluid. |
| Bioavailability | Not applicable (only IV route used clinically). |
| Onset of Action | Intravenous: 5-10 minutes. |
| Duration of Action | 1-3 hours; dose-dependent; uterus may remain refractory to oxytocin for up to 30 min after infusion stop. |
| Molecular Weight | 285.3 |
| Action Class | Beta 2 agonist - Uterus |
| Brand Substitutes | Isoxsprin 10mg Tablet, Unisox 10mg Tablet, Isox 10mg Tablet, Fetocare 10mg Tablet, Ecorit 10mg Tablet, Utgard 50mg Injection, Ritodine 50mg Injection, Ritrod 50mg Injection |
Initial dose of 50 mcg/min IV, increased by 50 mcg/min every 10-20 minutes until uterine contractions cease or maximum of 350 mcg/min is reached. Maintenance at the lowest effective dose for 12-24 hours after contractions stop.
| Dosage form | TABLET |
| Renal impairment | No specific dose adjustment is recommended; however, use with caution in patients with renal impairment as drug elimination may be reduced. |
| Liver impairment | No specific dose adjustment is recommended; however, use with caution in patients with hepatic impairment due to potential for altered metabolism. |
| Pediatric use | Not indicated for pediatric use; safety and efficacy in children have not been established. |
| Geriatric use | Not indicated for use in elderly patients; specifically used for preterm labor in pregnant women. |
| 1st trimester | Avoid in first trimester due to potential teratogenic effects; risk of pulmonary edema and fetal tachycardia. |
| 2nd trimester | Use only if clearly needed; risk of maternal pulmonary edema, fetal tachycardia, and neonatal hypoglycemia. |
| 3rd trimester | Use only if clearly needed; risk of maternal pulmonary edema, fetal tachycardia, and neonatal hypoglycemia. |
Clinical note
Comprehensive clinical and safety monograph for YUTOPAR (YUTOPAR).
| Placental transfer | Crosses placenta; fetal levels approximately 50% of maternal levels. |
| Breastfeeding | Excreted into breast milk in small amounts; monitor infant for tachycardia and hypoglycemia. |
| Lactation Rating |
■ FDA Black Box Warning
None.
| Serious Effects |
Hypersensitivity to ritodrineMaternal cardiac diseasePulmonary hypertensionHyperthyroidismUncontrolled diabetes mellitusSevere preeclampsiaEclampsiaHemorrhage requiring immediate deliveryIntrauterine infectionFetal deathFetal anomaly incompatible with lifeMultiple gestation with risk of fetal distress
| Precautions | Maternal pulmonary edema, especially with multiple gestation or concurrent corticosteroids., Maternal cardiac effects: tachycardia, myocardial ischemia, arrhythmias., Fetal effects: tachycardia, hypoglycemia, hypocalcemia, ileus., Hypokalemia due to beta-2 stimulation., Paradoxical bronchospasm in asthmatics. |
| Food/Dietary | Avoid high-sodium foods and excessive fluid intake to reduce risk of fluid retention and pulmonary edema. Limit caffeine-containing beverages, as they may exacerbate tachycardia. Grapefruit juice has no known interaction but should be consumed in moderation. Maintain a balanced diet with adequate potassium intake, as ritodrine can cause hypokalemia. |
Loading safety data…
| L3 (Moderately Safe) |
| Teratogenic Risk | FDA Pregnancy Category B. No evidence of teratogenicity in animal studies. In humans, limited data; use only if clearly needed. Risk of maternal pulmonary edema and fetal tachycardia at high doses; monitor fetal heart rate. |
| Fetal Monitoring | Monitor maternal heart rate, blood pressure, respiratory rate, serum potassium, and glucose. Fetal heart rate monitoring. Assess for signs of pulmonary edema (dyspnea, crackles). |
| Fertility Effects | No known adverse effects on fertility. Not indicated for use in non-pregnant women. |
| Clinical Pearls | YUTOPAR (ritodrine) is a beta-2 adrenergic agonist used for acute tocolysis. Monitor maternal heart rate and blood pressure closely; tachycardia >140 bpm may require dose reduction or discontinuation. Contraindicated in preeclampsia, eclampsia, and maternal cardiac disease. Concurrent use with corticosteroids (betamethasone) can increase risk of pulmonary edema. Administer IV with caution; limit fluid intake to 1500-2000 mL/day to reduce fluid overload risk. When switching to oral therapy, ensure overlapping IV and oral doses to maintain therapeutic levels. |
| Patient Advice | Report immediately any chest pain, shortness of breath, palpitations, or swelling of hands/feet. · Avoid sudden discontinuation; tapered dose reduction is necessary under medical supervision. · Limit fluid intake to prevent fluid overload; follow fluid restriction guidelines provided by your doctor. · Inform all healthcare providers you are taking this medication, especially before any surgery or emergency treatment. · Do not breastfeed while on this medication; use effective contraception during treatment. |