KAR-bo-prost

Therapeutic Classification: abortifacients

Pharmacologic Classification: oxytocics, prostaglandins

• Induction of mid-trimester abortion.
• Treatment of postpartum hemorrhage that has not responded to conventional therapy.

• Causes uterine contractions by directly stimulating the myometrium.

• Expulsion of fetus.
• Control of postpartum bleeding.

Absorption: Well absorbed following IM administration.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-life: Unknown.

(peak noted as mean abortion time)

Contraindicated in:

• Hypersensitivity
• Acute pelvic inflammatory disease
• Active pulmonary, renal, or hepatic disease.

Use Cautiously in:

• Uterine scarring
• Asthma
• Hypotension
• Hypertension
• Cardiac disease
• Adrenal disease
• Anemia
• Jaundice
• Diabetes mellitus
• Seizure disorders.

Derm: flushing.

GI: diarrhea, nausea, vomiting, abdominal pain, cramps.

GU: UTERINE RUPTURE.

Neuro: dizziness, headache.

Resp: wheezing.

Misc: fever, chills, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA), shivering.

Drug-Drug:

• Augments the effects of other oxytocic agents.

Test Dose

• IM (Adults): 100 mcg.

Abortifacient

• IM (Adults): 250 mcg every 1.5–3.5 hr depending upon uterine response; may be ↑ to 500 mcg if several doses of 250 mcg produce inadequate response (not to exceed 2 days of continuous therapy or total dose of 12 mg).

Refractory Postpartum Uterine Bleeding

• IM (Adults): 250 mcg; may be repeated every 15–90 min (total dose not to exceed 2 mg).

(Generic available)

• Solution for injection: 250 mcg/mL;

• Monitor frequency, duration, and force of contractions and uterine resting tone. Notify health care professional if contractions are absent or last more than 1 min.
• Monitor temperature, pulse, and BP periodically throughout course of therapy. Large dose may cause hypertension. Temperature elevation beginning 1 to 16 hr after initiation of therapy and lasting for several hours is not unusual.
• Monitor for signs and symptoms of anaphylaxis (wheezing, chest tightness, dyspnea, rash, pruritus, swelling of face, lips, or throat). Provide supportive care if symptoms occur.
• Assess for nausea, vomiting, and diarrhea. Vomiting and diarrhea occur in approximately two-thirds of patients. Premedication with antiemetic and antidiarrheal is recommended.
• Monitor amount and type of vaginal discharge. Notify health care professional immediately if symptoms of hemorrhage (increased bleeding, hypotension, pallor, tachycardia) occur.

• Avoid contact with skin. Thoroughly wash skin immediately after spillage.
  • Opioid analgesic may be given for uterine cramping.
  • Store in refrigerator.
• IM: Administer deep IM. Dose may be repeated every 1.5–3.5 hr. Rotate sites.

• Explain purpose of vaginal examinations (to assess for trauma to cervix).
  • Instruct patient to notify health care professional immediately if fever and chills, foul-smelling vaginal discharge, lower abdominal pain, or increased bleeding occurs.

• Complete abortion.
• Control of postpartum or post-abortal hemorrhage.

Hemabate

NDC Code^*

• 0009- Pharmacia and Upjohn Company LLC
  • 0009-0856- Hemabate
    • 0009-0856-05- 1 mL in 1 AMPULE (0009-0856-05)

• 0009- Pharmacia and Upjohn Company LLC
  • 0009-0856- Hemabate
    • 0009-0856-08- 10 AMPULE in 1 PACKAGE (0009-0856-08) > 1 mL in 1 AMPULE (0009-0856-05)

• 43598- Dr. Reddyøs Laboratories Inc.
  • 43598-698- Carboprost Tromethamine
    • 43598-698-58- 10 VIAL, SINGLE-DOSE in 1 CARTON (43598-698-58) > 1 mL in 1 VIAL, SINGLE-DOSE (43598-698-11)