• See Also
  1. Postpartum Hemorrhage
  2. Uterotonic
  • Indications
  1. Postpartum Hemorrhage (second-line agent)
  • Contraindications
  1. Asthma (relative contraindication)
  • Mechanism
  1. Carboprost is the synthetic methyl analog of Prostaglandin F2 alpha (PGF2a) which has Oxytocin-like activity
  2. Prostaglandin F2 alpha (PGF2a)
    1. PGF2a activates the Prostaglandin F receptor on Smooth Muscles resulting in their contraction
    2. PGF2a's primary effects are to trigger uterine, vascular and gastrointestinal sphincter smooth Muscle Contraction
  • Medications
  1. Carboprost Tromethamine (Hemabate) 250 mcg/ml (in 1 ml ampule)
  • Dosing
  1. Carboprost 250 mcg via deep IM Injection
  2. May repeat every 15 to 90 minutes for up to a total cummulative dose of 2 mg (8 doses)
  3. Test dose of 100 mcg may be given (if concerns for adverse effect)
  • Adverse Effects
  1. Bronchoconstriction
  2. Hypertension
  3. Flushing
  4. Fever (transient >2 F increase)
  5. Gastrointestinal (common, in up to two thirds of patients)
    1. Nausea or vomting
    2. Diarrhea
  • Safety
  1. Unknown safety in Lactation
  2. Contraindicated in pregnancy (except postpartum or after pregnancy loss)
  • Resources
  1. Carboprost Solution (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=3d282998-ff0c-480a-bd80-155606ef0a65