Carboprost Injection: Uses, Dosage, Side Effects & Administration

Summary of Key Points

Carboprost is a medication primarily used to manage postpartum hemorrhage and other uterine conditions, such as uterine atony and abortion. It works by stimulating uterine contractions, which help control bleeding or expel uterine contents. Carboprost is typically administered via injection and should only be used under the supervision of a healthcare provider. Always consult your doctor before starting or adjusting your dose of Carboprost.

Names of Medication

US Brand Name: Hemabate (Carboprost)

The generic name, Carboprost, is the active ingredient and remains consistent across all brands. In this case, Carboprost is the generic name, listed in parentheses.

Pharmacologic Category

Prostaglandins

Uterotonics

Carboprost Dosage Guidelines

Carboprost is used to treat various uterine-related conditions. Below are the recommended doses for each condition. Always consult your doctor before adjusting your dose or starting treatment. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.

1. Postpartum Hemorrhage: The typical dose is 250 mcg injected into the muscle. This dose may be repeated every 15 to 90 minutes as needed, but the total dose should not exceed 2 mg.
2. Uterine Atony: 250 mcg injected into the muscle. This dose may be repeated every 15 to 90 minutes as necessary, with a maximum total dose of 2 mg.
3. Abortion (Second Trimester): 250 mcg injected into the muscle every 1.5 to 3.5 hours until the abortion is complete. The total dose should not exceed 12 mg.
4. Missed Abortion: 250 mcg injected into the muscle every 1.5 to 3.5 hours as needed to complete the abortion.
5. Intrauterine Fetal Demise: 250 mcg injected into the muscle every 1.5 to 3.5 hours until uterine evacuation is complete.
6. Cervical Ripening: Carboprost is not typically used for cervical ripening, but your doctor may recommend other medications for this purpose.
7. Labor Induction: Carboprost is not commonly used for labor induction. Other medications, such as oxytocin, are generally preferred for this purpose.
8. Uterine Evacuation: 250 mcg injected into the muscle every 1.5 to 3.5 hours until the uterus is fully evacuated.
9. Severe Preeclampsia: Carboprost is not typically used to treat preeclampsia, but it may be used in certain cases to manage complications related to uterine bleeding.
10. Placenta Previa: Carboprost is not commonly used for placenta previa, but it may be administered in emergency situations to control bleeding.

Dosage Forms and Strengths

Injection: 250 mcg/mL in a 1 mL vial

Carboprost Administration Guidelines

Carboprost is administered by injection into a muscle, typically in a hospital or clinical setting. Your healthcare provider will determine the appropriate dose and frequency based on your condition. It is crucial to follow your doctor’s instructions carefully and report any side effects immediately. If you have concerns about using this medication, you can consult one of our providers through telemedicine for further guidance.

Carboprost Side Effects and Adverse Reactions

Like all medications, Carboprost may cause side effects. While not everyone experiences them, it’s important to be aware of potential reactions. If you notice any severe or unusual symptoms, contact your healthcare provider immediately.

Common Side Effects (Occurring in 10% or more of patients):

1. Nausea and Vomiting: Many patients experience nausea or vomiting after receiving Carboprost.
2. Diarrhea: Diarrhea is a common side effect and may occur shortly after the injection.
3. Fever: A mild fever may develop after receiving Carboprost.

Less Common Side Effects (Occurring in 1-10% of patients):

1. Flushing: Some patients report redness or warmth in the face or neck.
2. Chills: You may feel cold or experience shivering after the injection.
3. Headache: A mild headache may occur in some patients.

Rare but Serious Side Effects (Occurring in less than 1% of patients):

1. Severe Allergic Reactions: Symptoms may include rash, itching, swelling, dizziness, or difficulty breathing. Seek emergency medical attention if you experience these symptoms.
2. Severe Bleeding: Although Carboprost is used to control bleeding, in rare cases, it may cause excessive bleeding.
3. Cardiovascular Issues: In rare instances, Carboprost can cause high blood pressure or heart problems. Contact your doctor immediately if you experience chest pain or shortness of breath.

Carboprost Contraindications

A contraindication is a specific situation where a medication should not be used because it may cause harm. It’s important to know if you have any conditions or factors that make taking Carboprost unsafe. Below are the main contraindications for Carboprost:

1. Hypersensitivity to Carboprost: If you have a known allergy to Carboprost or any of its components, taking this medication can cause severe allergic reactions, including anaphylaxis, which can be life-threatening.
2. Acute Pelvic Inflammatory Disease (PID): Carboprost can worsen infections in the pelvic area, leading to severe complications. It should not be used if you have an active pelvic infection.
3. Severe Cardiovascular Disease: Carboprost can increase blood pressure and heart rate, which may be dangerous for people with heart conditions like uncontrolled hypertension or heart failure.
4. Severe Respiratory Disease: Carboprost can cause bronchospasm (tightening of the airways), which can be dangerous for people with asthma or other severe lung conditions.
5. Renal or Hepatic Impairment: If you have severe kidney or liver disease, your body may not process the medication effectively, leading to toxicity or other complications.

Drug to Drug Interactions

Carboprost can interact with other medications, potentially increasing the risk of side effects or reducing the effectiveness of either drug. It’s important to inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs and supplements. Below are some known drug interactions:

1. Oxytocin (Pitocin): Using Carboprost alongside oxytocin may increase the risk of uterine hyperstimulation, which could lead to complications such as uterine rupture.
2. Ergot Alkaloids (Methylergonovine, brand name Methergine): Combining Carboprost with ergot alkaloids may elevate the risk of severe hypertension and vascular issues.
3. Prostaglandin Analogues (Misoprostol, brand name Cytotec): Using multiple prostaglandins together can increase the likelihood of gastrointestinal side effects, including nausea, vomiting, and diarrhea.

Carboprost in Pregnancy

Is it Safe to Take Carboprost When Pregnant?

Carboprost is not safe for use in ongoing pregnancies. It is specifically prescribed to manage certain pregnancy-related conditions, such as postpartum hemorrhage or to induce abortion in cases of missed abortion or intrauterine fetal demise. If you are pregnant and considering Carboprost for any reason, it’s crucial to consult your healthcare provider to discuss the potential risks and benefits. For immediate advice, our telemedicine providers are available to assist you.

Carboprost While Breastfeeding

Is it Safe to Take Carboprost While Breastfeeding?

There is limited information on the safety of Carboprost during breastfeeding. Although it is commonly used to treat postpartum hemorrhage, caution is advised if you are breastfeeding. It’s essential to discuss with your healthcare provider whether it is safe to continue breastfeeding while taking this medication. If you have concerns, our telemedicine providers can help guide you through your options.

Estimated Cost of Carboprost

The cost of Carboprost can vary depending on the pharmacy and location. With a GoodRX coupon, the estimated cost for a 30-day supply of Carboprost without insurance ranges from approximately $100 to $150. For the most accurate pricing, check with your local pharmacy, and consider using a coupon to help reduce the cost.

Possible Alternatives to Carboprost

If Carboprost is not suitable for you, other treatment options are available depending on the condition being treated. Always consult your healthcare provider before making any changes to your treatment plan. Below are some possible alternatives:

1. Postpartum Hemorrhage: Alternatives include oxytocin (Pitocin), misoprostol (Cytotec), or surgical interventions such as uterine artery embolization. Discuss these options with your provider.
2. Uterine Atony: Oxytocin and methylergonovine (Methergine) are commonly used alternatives. Non-medication options include uterine massage or surgical procedures.
3. Abortion or Missed Abortion: Alternatives include misoprostol (Cytotec) or surgical options like dilation and curettage (D&C).
4. Intrauterine Fetal Demise: Misoprostol (Cytotec) or labor induction with oxytocin may be considered. Surgical evacuation is another option.
5. Cervical Ripening and Labor Induction: Misoprostol (Cytotec) or mechanical methods like a Foley catheter may be used as alternatives.
6. Uterine Evacuation: Surgical options such as dilation and curettage (D&C) or vacuum aspiration may be alternatives to Carboprost.
7. Severe Preeclampsia: Magnesium sulfate and antihypertensive medications are commonly used. In severe cases, delivery of the baby is the definitive treatment.
8. Placenta Previa: Management typically involves close monitoring, and in severe cases, a cesarean section may be necessary. Carboprost is not typically used for this condition.

Recent Updates on Carboprost Research

Recent studies have focused on improving the safety and effectiveness of Carboprost, particularly in managing postpartum hemorrhage. Ongoing research is exploring optimal dosing strategies to reduce common side effects such as nausea, vomiting, and diarrhea. Additionally, researchers are investigating the use of Carboprost in combination with other medications to enhance its effectiveness while minimizing risks. If you are interested in learning more about the latest research or have questions about how this might affect your treatment, our telemedicine providers are available to discuss your options.

James Kingsley

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