CARBOPROST TROMETHAMINE
(kar'boe-prost)
Hemabate
Classifications: prostaglandin; abortifacient
Prototype: Dinosprostone
Pregnancy Category: D

Availability

250 mcg/mL injection

Actions

Synthetic analog of naturally occurring prostaglandin F2 alpha with longer duration of biologic activity. Stimulates myometrial contractions of gravid uterus; contractions are qualitatively similar to those occurring at term labor. Mean time to abortion 16 h; mean dose required 2.6 mL. Length of time to abortion and total dose of carboprost required decrease with greater parity but increase with greater gestational age. Can be employed as abortifacient even if membranes are ruptured.

Therapeutic Effects

Effectively stimulates uterine contraction and is used to induce abortion over a wide range of gestational age. Useful in treatment of postpartum hemorrhage due to uterine atony unresponsive to usual measures.

Uses

To induce abortion between 13th and 20th week of pregnancy, as calculated from first day of last menstrual period. Also for refractory postpartum bleeding.

Unlabeled Uses

To reduce blood loss secondary to uterine atony; to induce labor in intrauterine fetal death and hydatidiform mole.

Contraindications

Acute pelvic inflammatory disease; active cardiac, pulmonary, renal, or hepatic disease; pregnancy (category D); lactation.

Cautious Use

History of asthma; adrenal disease; anemia; hypotension; hypertension; diabetes mellitus; epilepsy; history of uterine surgery; cervical stenosis; fibroids.

Route & Dosage

Abortion, Postpartum Bleeding
Adult: IM Initial: 250 mcg (1 mL) repeated at 1 –3 -h intervals if indicated by uterine response. Dosage may be increased to 500 mcg (2 mL) if uterine contractility is inadequate after several doses of 250 mcg (1 mL), not to exceed total dose of 12 mg or continuous administration for more than 2 d.

Administration

Adverse Effects (1%)

Body as a Whole: Fever, flushing, chills, cough, headache, pain (muscles, joints, lower abdomen, eyes), hiccups, breast tenderness. GI: Nausea, diarrhea, vomiting.

Pharmacokinetics

Peak: After IM injection, time to peak in plasma is 30–90 mins. Elimination: Renal within 24 hrs.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education


Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug