carboprost

Carboprost tromethamine, sold under the brand name Hemabate among others, is a synthetic prostaglandin F2α analogue used in obstetrics. It is indicated for the treatment of postpartum hemorrhage due to uterine atony and for inducing abortion in selected settings, typically in the second trimester or when other methods are appropriate.

Carboprost works by stimulating uterine contractions through prostaglandin F2α receptors, promoting expulsion of placental tissue or reduction of uterine bleeding. Its effects are primarily on smooth muscle of the uterus, but systemic smooth muscle can be affected, leading to a range of responses such as cramping and other autonomic symptoms.

Administration and dosing commonly involve intramuscular injections of 250 micrograms (0.25 mg) every 15 to 90 minutes as needed, with a typical total dose not to exceed about 2 mg. Dosing may be used similarly for abortion induction, continuing until the desired outcome is achieved. Dosing schedules are chosen to balance efficacy with the risk of adverse effects.

Contraindications include hypersensitivity to carboprost or other prostaglandins. Caution is advised in patients with asthma, significant cardiovascular disease, hepatic or renal impairment, or other conditions that predispose to bronchospasm or excessive smooth muscle contraction. Pregnant patients with ongoing fever or infection, or those at risk for uterine hyperstimulation, require careful consideration. Adverse effects commonly reported include nausea, vomiting, diarrhea, fever, chills, headache, abdominal cramping, flushing, and uterine tenderness; bronchospasm and tachycardia may occur, particularly in patients with asthma or other risk factors.