II. Indications

  1. Postpartum Hemorrhage (second-line agent)

III. Contraindications

  1. Asthma (relative contraindication)

IV. 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

V. Medications

  1. Carboprost Tromethamine (Hemabate) 250 mcg/ml (in 1 ml ampule)

VI. 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)

VII. 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

VIII. Safety

  1. Unknown safety in Lactation
  2. Contraindicated in pregnancy (except postpartum or after pregnancy loss)

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Carboprost (C0007047)

Definition (NCI) 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.
Definition (MSH) A nonsteroidal abortifacient agent that is effective in both the first and second trimesters of PREGNANCY.
Concepts Pharmacologic Substance (T121) , Eicosanoid (T111)
MSH D002260
SnomedCT 109057004, 373455002
English 15(S)-15-Methyl PGF2alpha, 15-Methylprostaglandin F2alpha, Carboprost, 15 Methylprostaglandin F2alpha, Prosta-5,13-dien-1-oic acid, 9,11,15-trihydroxy-15-methyl-, (5Z,9alpha,11alpha,13E,15S)-, carboprost, METHYLPROSTAGLANDIN F2ALPHA A 15, Methyl-PGF2-alpha, Prostin 15M, (15S)-15-Methyl-PGF2alpha, Carboprost [Chemical/Ingredient], CARBOPROST, Carboprost (product), Carboprost (substance)
Swedish Karboprost
Czech karboprost
Finnish Karboprosti
Russian KARBOPROST, 15-METILPROSTAGLANDIN F2 AL'FA, 15-METILPROSTAGLANDINA F2 AL'FA METILOVYI EFIR, METILDINOPROST, 15-МЕТИЛПРОСТАГЛАНДИН F2 АЛЬФА, 15-МЕТИЛПРОСТАГЛАНДИНА F2 АЛЬФА МЕТИЛОВЫЙ ЭФИР, КАРБОПРОСТ, МЕТИЛДИНОПРОСТ
Japanese カルボプロスト, 15-メチルプロスタグランジンF2アルファ, 15-メチルプロスタグランジンF2α
German METHYLPROSTAGLANDIN F2ALPHA A 15, 15-Methylprostaglandin-F2-Alpha, Carboprost
Polish Karboprost, 15-metyloprostaglandyna F2 alfa
Portuguese Carboprost, 15-Metilprostaglandina F2 alfa, Carboprosta
Spanish carboprost (producto), carboprost (sustancia), carboprost, 15-Metilprostaglandina F2 alfa, Carboprost
French Carboprost
Italian Carboprost

Ontology: carboprost tromethamine (C0054721)

Definition (NCI) 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.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C062843
SnomedCT 109058009
English 15-methylprostaglandin F2alpha-tromethamine, carboprost tromethamine, carboprost trometamol, (15S)-15-Methylprostaglandin F(sub 2alpha) Tromethamine, (15S)-9a, 11a, 15-Trihydroxy-15-methyl-prosta-cis-5, trans-13-dienoic Acid Tromethamine Salt, Prosta-5,13-dien-1-oic acid, 9,11,15-trihydroxy-15-methyl-,(5Z,9-alpha,11-alpha,13E,15S)-, compound with 2-Amino-2-(hydroxymethyl)-1,3-propanediol(1:1), CARBOPROST/TROMETHAMINE, Carboprost trometamol, prostaglandins carboprost tromethamine, carboprost tromethamine (medication), CARBOPROST TROMETHAMINE, Carboprost tromethamine (substance), Carboprost tromethamine, Carboprost Tromethamine
Spanish carboprost trometamina (sustancia), carboprost trometamina, carboprost trometamol, carboprost trometamol (sustancia)