Carboprost

What is Carboprost?

• Carboprost (Hemabate) is an oxytocic, contains the tromethamine salt of the (15S)-15 methyl analogue of naturally occurring prostaglandin F2α.

Carboprost

What are the uses of this medicine?

Carboprost (Hemabate) is used for aborting pregnancy between the 13th and 20th weeks of gestation. Carboprost is used in the following conditions related to second trimester abortion:

• Failure of expulsion of the fetus during the course of treatment by another method;
• Premature rupture of membranes in intrauterine methods with loss of drug and insufficient or absent uterine activity;
• Requirement of a repeat intrauterine instillation of drug for expulsion of the fetus;
• Inadvertent or spontaneous rupture of membranes in the presence of a previable fetus and absence of adequate activity for expulsion.

• Carboprost is indicated for the treatment of postpartum hemorrhage due to uterine atony which has not responded to conventional methods of management.
• Carboprost's main use is in the obstetrical emergency of postpartum hemorrhage which reduces postpartum bleeding during these circumstances.

How does this medicine work?

• The tromethamine salt of the (15S)-15 methyl analogue of naturally occurring prostaglandin F2 alpha (PGF2 alpha) with oxytocic activity.
• Mimicking endogenous PGF2 alpha, carboprost activates prostaglandin F receptor, a G-protein coupled receptor, on smooth muscle cells, thereby resulting in smooth muscle contractions.
• When administered intramuscularly on gravid subjects, this agent induces myometrium contractions, thereby initiating luteolysis and consequently parturition.
• Furthermore, carboprost's action on vascular smooth muscle and gastrointestinal tract sphincters leads to raised blood pressure and induces vomiting or diarrhea, respectively.

Who Should Not Use this medicine ?

This medicine have cannot be used in patients with:

• Hypersensitivity (including anaphylaxis and angioedema) to Hemabate Sterile Solution
• Acute pelvic inflammatory disease
• active cardiac, pulmonary, renal or hepatic disease

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

• Be sure to mention any of the following:
• Concomitant use with other oxytocic agents is not recommended.

Is this medicine FDA approved?

• Yes, it was FDA approved.

How should this medicine be used?

Recommended dosage:

• An initial dose of 1 mL of Hemabate Sterile Solution is to be administered deep in the muscle with a tuberculin syringe.
• Subsequent doses of 250 micrograms should be administered at 1½ to 3½ hour intervals depending on uterine response.
• An optional test dose of 100 micrograms (0.4 mL) may be administered initially.
• The dose may be increased to 500 micrograms (2 mL) if uterine contractility is judged to be inadequate after several doses of 250 micrograms (1 mL).
• The total dose administered of carboprost tromethamine should not exceed 12 milligrams and continuous administration of the drug for more than two days is not recommended.

Administration:

• An initial dose of 250 micrograms of Hemabate Sterile Solution (1 mL of Hemabate) is to be given deep, intramuscularly.
• The total dose of Hemabate should not exceed 2 milligrams (8 doses).
• Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Hemabate Sterile Solution
• Hemabate contains carboprost tromethamine equivalent to 250 mcg/mL of carboprost.

This medicine is available in fallowing brand namesː

• Hemabate

What side effects can this medication cause?

The most common side effects of this medicine include:

• Vomiting
• Nervousness
• Diarrhea
• Nosebleed
• Nausea
• Sleep disorders
• Flushing or hot flashes
• Dyspnea
• Chills or shivering
• Tightness in chest
• Coughing
• Wheezing
• Headaches
• Posterior cervical perforation
• Endometritis
• Weakness
• Hiccough
• Diaphoresis
• Dysmenorrhea-like pain
• Dizziness
• Paresthesia
• Blurred vision
• Backache
• Epigastric pain
• Muscular pain
• Excessive thirst
• Breast tenderness
• Twitching eyelids
• Eye pain
• Gagging, retching
• Drowsiness
• Dry throat
• Dystonia
• Sensation of choking
• Asthma
• Thyroid storm
• Injection site pain
• Syncope
• Tinnitus
• Palpitations
• Vertigo
• Rash
• Vaso-vagal syndrome
• Upper respiratory infection
• Dryness of mouth
• Leg cramps
• Hyperventilation
• Perforated uterus
• Respiratory distress
• Anxiety
• Hematemesis
• Chest pain
• Taste alterations
• Retained placental fragment
• Urinary tract infection
• Shortness of breath
• Septic shock
• Fullness of throat
• Torticollis
• Uterine sacculation
• Lethargy
• Faintness, light-headedness
• Hypertension
• Uterine rupture
• Tachycardia
• Pulmonary edema
• Endometritis from IUCD

What special precautions should I follow?

• Hemabate Sterile Solution (carboprost tromethamine), like other potent oxytocic agents, should be used only with strict adherence to recommended dosages.
• Hemabate should be used by medically trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities.
• This product contains benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants.
• In patients with a history of asthma, hypo- or hypertension, cardiovascular, renal, or hepatic disease, anemia, jaundice, diabetes, or epilepsy, Hemabate should be used cautiously.
• As with any oxytocic agent, Hemabate should be used with caution in patients with compromised (scarred) uteri.

What to do in case of emergency/overdose?

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Can this medicine be used in pregnancy?

• Evidence from animal studies has suggested that certain other prostaglandins have some teratogenic potential.
• Although these studies do not indicate that Hemabate is teratogenic, any pregnancy termination with Hemabate that fails should be completed by some other means.

Can this medicine be used in children?

• Safety and effectiveness in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• CARBOPROST TROMETHAMINE

Inactive ingredients:

• TROMETHAMINE
• SODIUM CHLORIDE
• BENZYL ALCOHOL
• SODIUM HYDROXIDE
• HYDROCHLORIC ACID

Who manufactures and distributes this medicine?

Distributed by:

• Pharmacia & Upjohn Co
• Division of Pfizer Inc, NY

What should I know about storage and disposal of this medication?

• Hemabate must be refrigerated at 2° to 8° C (36° to 46° F).

• Dailymed label info on Carboprost
• FDA Carboprost

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