Atosiban (Tocolysis)

How it works

It competitively blocks oxytocin receptors on the myometrium, reducing the frequency and intensity of uterine contractions.

Prescribing in practice

• It is intended only to provide short-term delay of preterm delivery, typically to allow time for antenatal corticosteroids and in-utero transfer, not to treat the underlying cause.
• It is contraindicated where prolonging the pregnancy would be hazardous, such as in suspected intrauterine infection, antepartum haemorrhage requiring delivery, eclampsia, or fetal compromise.
• It is given by intravenous infusion under specialist supervision following a defined initial bolus and maintenance regimen.

Monitoring

Monitor uterine contractions, fetal wellbeing, and maternal blood loss during and after the infusion.

Counselling the patient

• Explain that this medicine aims to delay your labour for a short period to allow other treatments to protect the baby.
• Report any increase in bleeding, abdominal pain, or reduced fetal movements to staff.
• It is given as a drip in hospital and you will be closely monitored throughout.

Evidence & guidelines

Atosiban and other tocolytics are used, as reflected in NICE guidance on preterm labour and birth, mainly to enable corticosteroid administration and transfer rather than to improve neonatal outcomes directly.