Carboprost

Indications

Carboprost is used for: Pregnancy termination in the 2nd trimester (Abortion), Postpartum Uterine Bleeding

Adult Dose

Intramuscular Pregnancy termination in the 2nd trimester/Abortion Adult: Initially, 250 mcg. Alternatively, initiate w/ test dose of 100 mcg. May be repeated at 1.5- to 3.5-hr intervals depending on uterine response. May be increased to 500 mcg if uterine contractility is inadequate. Max: 12 mg. Max duration: 2 days. Intramuscular Postpartum haemorrhage Adult: Initially, 250 mcg by deep inj. May be repeated every 15-90-min. Max: 2 mg.

Child Dose

Renal Dose

Administration

Contra Indications

Acute pelvic inflammatory disease; active cardiac, pulmonary, renal or hepatic disease.

Precautions

History of glaucoma or raised IOP Asthma, hypertension/hypotension, cardiovascular disease Transient fever observed with treatment possibly as a result of carboprost's effect on hypothalamic thermoregulation Caution in patients with anemia, jaundice, renal impairment, hepatic impairment diabetes or epilepsy To decrease GI side effects pretreatment or concomitant use with antiemetic and antidiarrheal agents recommended Not for IV Rare cases of cardiovascular collapse reported with prostaglandins Lactation: Excretion in milk unknown

Pregnancy-Lactation

Pregnancy Category: C Lactation: Excretion in milk unknown

Interactions

May potentiate effect of other oxytocics.

Adverse Effects

Side effects of Carboprost : Nausea (1/3 patients), Vomiting (~2/3 patients), Diarrhea (~2/3 patients) Nervousness, Epistaxis, Sleep disorder, Hyperthermia, Flushing, Asthma, Wheezing, Coughing, Chest pain, Hypertension, Syncope, Palpation, Tachycardia, Chest tightness, Anxiety, Chills/shivering, Dizziness, Drowsiness, Dystonia, Faintness, Headache, Lethargy, Lightheadedness, Vertigo, Rash, Breast tenderness, Dysmenorrhea-like pain, Hot flashes, Dry throat.Taste alterations, Uterine bleeding (excessive) Local: injection site pain Backache, Leg cramps, Muscular pain, Parethesia, Blurred vision, Eye pain, Eyelid twitching, Tinnitus, Bronchospasm, Dyspnea, Hiccups

Mechanism of Action

Carboprost, a synthetic analogue of naturally occurring prostaglandin F2α, stimulates uterine contractility, resulting in expulsion of the products of conception. It is also used to induce abortion between 13-20 wk of pregnancy. It produces myometrial contractions responsible for placental haemostasis.