Adult Dosing

Termination of pregnancy (13-20 wks)

• 250 mcg IM q90-210 mins
• Start: 100 mcg IM test dose; Max: 12 mg or use x 2 days; may increase dose to 500 mcg if uterine contractility not adequate after several 250 mcg doses

Postpartum hemorrhage

• 250 mcg IM x 1
• Max: 2 mg IM total dose; may repeat q15-90 mins; for refractory bleeding

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Indicated for aborting pregnancy between the 13th and 20th weeks of gestation
• Treatment of refractory postpartum hemorrhage due to uterine atony

• Hypersensitivity to any of the ingredients of the product
• Acute pelvic inflammatory disease
• Patients with active cardiac, pulmonary, renal or hepatic disease

• Like other oxytocic agents, use only with strict adherence to recommended dosages
• Should be used by medically trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities

Renal Dose Adjustment

• Acute renal impairment: Contraindicated

Hepatic Dose Adjustment:

• Acute hepatic impairment: Contraindicated

• Like other oxytocic agents, use only with strict adherence to recommended dosages. Should be used by medically trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities [US Black Box Warning]
• Should not be considered a feticidal agent. It is not indicated if the fetus in utero has reached the stage of viability
• Use with caution in patients with compromised (scarred) uteri

Cautions: Use cautiously in

• Asthma or history of asthma
• Hypotension
• HTN
• CAD
• Anemia
• Diabetes mellitus
• Seizure disorder
• Uterine scar
• Chorioamnionitis

Pregnancy Category:C

Breastfeeding: Safety unknown.

• CNS: Dizziness, headache, drowsiness, paresthesia, dystonia
• CV: Hypertension
• RESP: Wheezing, pulmonary edema, respiratory distress, cough, hiccups, bronchospasm
• GI: Diarrhea, nausea, vomiting, abdominal pain, cramps, dry mouth
• GU: Uterine rupture, endometritis, incomplete abortion, UTI
• HEMA: Hematemesis, hemorrhage
• DERM: Flushing
• MISC: Fever, chills, shivering, pain

• Prostaglandin analogue; stimulates smooth muscle resulting in uterine contraction
• Rapidly absorbed following IM administration
• Primarily metabolized by liver
• Excreted in urine as metabolites (83%)
• Half-life: Unknown

US Trade Name(s)

• Hemabate

US Availability

Hemabate

• INJ: 250 mcg/mL (1 mL amp)

Canadian Trade Name(s)

• Hemabate

Canadian Availability

Hemabate

• INJ: 250 mcg/mL (1 mL amp)

UK Trade Name(s)

• Hemabate

UK Availability

Hemabate

• INJ: 250 mcg/mL (1 mL amp)

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Obstetrics/Gynecology

Abortifacients

Prostaglandins