Gynipral (Hexoprenaline Sulfate)

Gynipral is indicated for obstetric situations where inhibition of uterine contractions is required, particularly in the management of preterm labor and related conditions.

• Acute preterm labor to delay delivery for corticosteroid administration.
• Tocolysis during threatened preterm birth when other agents are contraindicated.
• Suppression of uterine activity during certain obstetric procedures.
• Management of uterine hyperstimulation after oxytocin infusion.
• Short‑term use in clinical trials evaluating novel tocolytic strategies.

The pharmacologic action of hexoprenaline sulfate can produce a range of adverse effects, which are generally categorized by frequency and severity.

Common

• Transient tachycardia or palpitations.
• Mild tremor of the hands or limbs.
• Headache or dizziness.
• Flushing of the face and neck.

Serious

• Significant hypotension or cardiovascular collapse.
• Severe bronchospasm in patients with reactive airway disease.
• Fetal distress indicated by abnormal heart rate patterns.

Because Gynipral influences smooth muscle tone and cardiovascular function, several precautions should be observed before and during therapy.

• Verify maternal cardiovascular status; avoid use in uncontrolled hypertension.
• Assess for a history of cardiac arrhythmias or ischemic heart disease.
• Use cautiously in patients with asthma or chronic obstructive pulmonary disease.
• Monitor fetal heart rate continuously during infusion.
• Limit duration of therapy; prolonged use may increase risk of adverse outcomes.
• Ensure appropriate dosing under specialist supervision; do not exceed recommended infusion rates.

Hexoprenaline sulfate may interact with other medications, altering its efficacy or increasing the risk of adverse events.

Avoid

• Concurrent use with non‑selective beta‑blockers, which can blunt the tocolytic effect.
• Combination with other potent vasodilators that may precipitate severe hypotension.

Use with caution

• Co‑administration with magnesium sulfate, as additive uterine relaxation may occur.
• Concurrent use of sympathomimetic agents (e.g., epinephrine) that could enhance cardiovascular stimulation.
• Caution when given with inhaled bronchodilators, as additive beta‑2 activity may increase tremor.