II. Indications
- Postpartum Hemorrhage (second-line agent)
III. Contraindications
- Asthma (relative contraindication)
IV. Mechanism
- Carboprost is the synthetic methyl analog of Prostaglandin F2 alpha (PGF2a) which has Oxytocin-like activity
-
Prostaglandin F2 alpha (PGF2a)
- PGF2a activates the Prostaglandin F receptor on Smooth Muscles resulting in their contraction
- PGF2a's primary effects are to trigger uterine, vascular and gastrointestinal sphincter smooth Muscle Contraction
V. Medications
- Carboprost Tromethamine (Hemabate) 250 mcg/ml (in 1 ml ampule)
VI. Dosing
- Carboprost 250 mcg via deep IM Injection
- May repeat every 15 to 90 minutes for up to a total cummulative dose of 2 mg (8 doses)
- Test dose of 100 mcg may be given (if concerns for adverse effect)
VII. Adverse Effects
- Bronchoconstriction
- Hypertension
- Flushing
- Fever (transient >2 F increase)
- Gastrointestinal (common, in up to two thirds of patients)
VIII. Safety
- Unknown safety in Lactation
- Contraindicated in pregnancy (except postpartum or after pregnancy loss)
IX. Resources
- Carboprost Solution (DailyMed)