Atosiban

Peptide

Atosiban is a nonapeptide oxytocin/vasopressin receptor antagonist for preterm labor. EMA-approved 2000, used in 68+ countries (NOT FDA-approved in US). A-GRADE evidence: Significantly more patients undelivered at 48h and 7 days vs placebo (P≤0.008) at ≥28 weeks gestation. Similar efficacy to beta-agonists but dramatically better tolerated (7.9% vs 70.8% adverse events vs ritodrine). Cochrane review: No superiority vs placebo or other tocolytics for NEONATAL outcomes - delays delivery but doesn't improve baby outcomes. CAUTION at <28 weeks (one trial noted increased fetal deaths). PRESCRIPTION ONLY.

Quick Answer

What it is

Atosiban is a nonapeptide oxytocin/vasopressin receptor antagonist for preterm labor. EMA-approved 2000, used in 68+ countries (NOT FDA-approved in US).

Key findings

Grade A: Pregnancy Prolongation (48h-7 days) (Preterm Labor)
Grade A: Maternal Tolerability vs Beta-Agonists (Preterm Labor)
Grade A: Tocolytic Efficacy vs Beta-Agonists (Preterm Labor)

Safety

Similar efficacy to beta-agonists but dramatically better tolerated (7.9% vs 70.8% adverse events vs ritodrine).
CAUTION at <28 weeks (one trial noted increased fetal deaths).
vs Ritodrine: Adverse events 7.9% vs 70.8%, early termination 0% vs 20%.

⚠️ Research Notice

This peptide information is for educational and research purposes only. Peptides may not be FDA-approved for human use and may only be legally available for research purposes. Consult qualified healthcare professionals before considering any peptide compounds.

ℹ️ Quick Facts: Atosiban

Quick Facts: Atosiban

Best Evidence:Grade A
Conditions Studied:1
Research Outcomes:9
Grade A Findings:5
Grade B Findings:1
Key Effect:Preterm Labor

1 conditions · 9 outcomes

Detailed Outcomes

Pregnancy Prolongation (48h-7 days)

Romero Phase 3 (n=501): Significantly more undelivered at 24h, 48h, and 7 days vs placebo (all P≤0.008) at ≥28 weeks. Allows time for corticosteroid administration. Less effective at <28 weeks gestational age.

moderate↑Improves

Maternal Tolerability vs Beta-Agonists

vs Ritodrine: Adverse events 7.9% vs 70.8%, early termination 0% vs 20%. vs Salbutamol: Better tolerated with comparable efficacy. vs Terbutaline: Fewer clinically important adverse events. No cardiovascular side effects seen with beta-agonists.

large↑Improves

Tocolytic Efficacy vs Beta-Agonists

vs Salbutamol: 48h efficacy 93.3% vs 95.0% (P=0.67). vs Terbutaline: 48h efficacy 86.1% vs 85.3% (P=0.78). Comparable tocolytic effectiveness with better safety profile. Some trials suggest slightly lower initial success rate.

none

Neonatal Outcomes

Cochrane 2014: No superiority vs placebo, beta-agonists, or CCBs for neonatal outcomes. Similar neonatal morbidity across comparators. One trial noted increased fetal deaths at <24 weeks - use caution at early gestational ages.

none

Maternal Side Effects

Most common: Nausea (mild). No tachycardia, hypotension, or hyperglycemia seen with beta-agonists. No pulmonary edema risk. Fewer treatment discontinuations. Generally well-tolerated by mother and fetus.

large↓Improves

Reproductive Outcomes

8 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

moderate↑Improves

Pulmonary Function

4 preclinical studies support this finding. Primarily preclinical evidence.

small↑Improves

Safety/Tolerability

2 systematic reviews and preclinical studies support this finding. Evidence includes systematic reviews/meta-analyses. Primarily preclinical evidence.

small↑Improves

Pain

2 preclinical studies support this finding. Primarily preclinical evidence.

small↓Improves