Carboprost Tromethamine Brand Name– Hemabate
What is Carboprost Tromethamine
Carboprost tromethamine is the tromethamine salt of the (15S)-15 methyl analogue of naturally occurring prostaglandin F2-alpha.
Clinically, carboprost tromethamine, an oxytocic, is used as a treatment for refractory postpartum uterine bleeding and as an abortifacient in gestation weeks 13 to 20 or in the second trimester under specific conditions.
Comparative data for abortion are available for another FDA-approved prostaglandin analogue, dinoprostone.
Among pregnant women of 14—24 weeks gestation, the cumulative abortion rate after 24 hours of drug receipt was 96% with dinoprostone 20 mg intravaginal suppositories and was 69% with carboprost 250 mcg IM; 8 patients who got carboprost as compared with 1 patient who got dinoprostone delivered after 24 hours of drug receipt.
The mean times to delivery of the fetus and of the placenta were significantly shorter with dinoprostone, but carboprost is recommended to be given every 1.5—3 hours whereas dinoprostone is given every 3—5 hours; in the study, both drugs were given every 3 hours until delivery.
Treatment selection is highly physician specific; consider medical history of patient, gestational age of fetus, and the availability of emergency medical and follow-up care.
The high incidence of transient gastrointestinal adverse events, the possibility of incomplete expulsion of uterine contents, and patient disfavor of IM administration may limit carboprost tromethamine use. Sales of carboprost are restricted to hospitals only.
Carboprost was approved by the FDA in 1979.
Indications
- hemorrhagic cystitis
- postpartum bleeding
- pregnancy termination
Side Effects
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- anxiety
- back pain
- blurred vision
- bronchospasm
- cervical laceration
- chest pain (unspecified)
- chills
- cough
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dysmenorrhea
- dyspnea
- dystonic reaction
- epistaxis
- fever
- flushing
- headache
- hematemesis
- hot flashes
- hypertension
- hyperventilation
- injection site reaction
- insomnia
- lethargy
- mastalgia
- muscle cramps
- musculoskeletal pain
- nausea
- ocular pain
- palpitations
- paresthesias
- pulmonary edema
- rash
- shivering
- sinus tachycardia
- syncope
- thyrotoxicosis
- tinnitus
- torticollis
- uterine rupture
- vertigo
- vomiting
- weakness
- wheezing
- xerostomia
Monitoring Parameters
- pelvic exam
- pregnancy testing
Contraindications
- anemia
- asthma
- benzyl alcohol hypersensitivity
- breast-feeding
- caesarean section
- cardiac disease
- children
- chorioamnionitis
- diabetes mellitus
- hepatic disease
- hypertension
- hypotension
- incomplete abortion
- infants
- infection
- jaundice
- neonates
- pregnancy
- pulmonary disease
- renal disease
- seizure disorder
- surgery
- trauma
Interactions
- Dinoprostone, Prostaglandin E2
- Ergonovine
- Methylergonovine
- Oxytocin
