Generic
Carboprost
1 brands available in the market
At a glance
Carboprost is a synthetic prostaglandin analogue used to terminate pregnancy between 13-20 weeks of gestation and to control postpartum uterine bleeding. It stimulates uterine contractions and ensures placental hemostasis.
Description
Carboprost is a synthetic analogue of naturally occurring prostaglandin F2α that stimulates uterine contractility, resulting in expulsion of the products of conception. It is used to induce abortion between 13-20 weeks of pregnancy. It produces myometrial contractions responsible for placental hemostasis.
Carboprost tromethamine administered intramuscularly stimulates myometrial contractions in the gravid uterus similar to labor contractions at the end of a full-term pregnancy. It also stimulates smooth muscle of the gastrointestinal tract (causing vomiting/diarrhea) and can elevate body temperature. Large doses can raise blood pressure by contracting vascular smooth muscle.
Indications
- Termination of pregnancy between 13-20 weeks of gestation (2nd trimester abortion)
- Postpartum uterine hemorrhage (refractory to conventional treatments)
Therapeutic class
Drugs acting on the Uterus
Pharmacological class
Prostaglandin Analogue (PGF2α)
Pharmacology
Carboprost tromethamine administered intramuscularly stimulates myometrial contractions in the gravid uterus similar to labor contractions at term. These contractions evacuate the products of conception from the uterus. Postpartum, myometrial contractions provide hemostasis at the placentation site. Carboprost also stimulates gastrointestinal smooth muscle (causing vomiting/diarrhea) and can elevate body temperature. Large doses can raise blood pressure by contracting vascular smooth muscle.
Mechanism of action
Carboprost activates prostaglandin receptors on uterine myometrium, causing uterine contractions that expel the products of conception and ensure placental hemostasis.
Dosage
Abortion (13-20 weeks): Initial dose: 250 mcg (1 mL) deep IM injection. Repeat 250 mcg every 1.5-3.5 hours based on uterine response. Optional test dose: 100 mcg (0.4 mL). May increase to 500 mcg (2 mL) if uterine contractility is inadequate. Maximum total dose: 12 mg. Maximum duration: 2 days.
Postpartum Uterine Hemorrhage: Initial dose: 250 mcg (1 mL) deep IM injection. Repeat 250 mcg every 15-90 minutes as needed. Maximum total dose: 2 mg (8 doses).
Note: For use in a hospital setting by trained medical personnel only.
Administration
For deep IM injection only. Administered by healthcare professionals. Patient should not self-administer.
Missed dose
Hospital-only medicine. Administered by doctor or nurse. Missed dose concept does not apply (hospital-administered).
Side effects
Common (smooth muscle contractile effects): Vomiting, nausea, diarrhea, pyrexia (fever), flushing (sense of warmth), headache, chills, cough, placental retention.
Other: Endometritis, retained placental fragments, excessive uterine bleeding (post-abortion complications), transient temperature increase, transient bronchoconstriction.
Large doses may raise blood pressure.
Precautions & warnings
- Use only in a hospital setting by trained medical personnel with immediate intensive care and surgical facilities.
- Use with caution in patients with history of asthma, hypo- or hypertension, cardiovascular, renal or hepatic disease, anemia, jaundice, diabetes, epilepsy, and compromised (scarred) uteri.
- In patients with chorioamnionitis, the uterus may not respond to carboprost.
- Examine the cervix immediately post-abortion.
- Do not use during pregnancy (abortion/postpartum use only).
- Know your response before driving (may cause unconsciousness, dizziness, drowsiness).
Contraindications
- Hypersensitivity to carboprost
- Acute pelvic inflammatory disease
- Active cardiac, pulmonary, renal, or hepatic disease
Drug interactions
- Other oxytocic agents (oxytocin, ergometrine): May potentiate carboprost effects; concomitant use is not recommended.
Food interactions
It is not known whether it is safe to consume alcohol with Carboprost; please consult your doctor.
Use in pregnancy
Highly unsafe during pregnancy (used only for abortion). Animal and human studies have shown significant harmful effects to the developing baby.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Caution during breastfeeding. Breastfeeding should be withheld until treatment is completed and the drug is eliminated from the body.
Pediatric use
Not indicated for use in children.
Geriatric use
Not indicated for use in elderly.
Renal / hepatic impairment
Hepatic impairment: Not recommended in active liver disease; caution required; dose adjustment may be needed.
Overdose effects
Overdose may cause severe uterine hyperstimulation, excessive uterine contractions, uterine rupture, severe vomiting/diarrhea, hypertension, bronchospasm, fever. Treatment: Supportive and symptomatic.
Storage conditions
Store at 2-8°C. Do not freeze. Keep away from light. Once the ampoule has been opened, use immediately.
Chemical structure
Carboprost Tromethamine (Prostaglandin F2α Analogue)