Carboprost tromethamine (Hemabate®)

Section 1.1

Midwives may independently prescribe, order and administer this drug.

(Hemabate®) is a prostaglandin which stimulates uterine contractility. Hemostasis at the placentation site is achieved through the myometrial contractions produced.

For treatment of postpartum hemorrhage due to uterine atony that is unresponsive to conventional methods of management.

Used as a third-line agent only after oxytocin and ergonovine maleate or as a second-line agent after oxytocin when ergonovine maleate is not available or contraindicated.

Contraindications:

Carboprost should not be used if there is active cardiac, pulmonary or renal disease, hypersensitivity to prostaglandins or active pelvic inflammatory disease.

Warnings and Precautions:

Use with caution in patients with hypertension, hypotension, anemia, history of asthma, history of scarred uterus, diabetes mellitus or history of seizure disorders.

Must be refrigerated at 2° to 8°C. (Check specific manufacturer product monograph for most accurate storage conditions.)

Pregnancy:

Contraindicated (unless for Termination/Evacuation of Pregnancy)

Lactation:

Category L3 – No Human Data – Probably Compatible

Adverse Reactions:

Nausea, vomiting, diarrhea, chills, shivering, transient elevated temperature, transient bronchoconstriction, headache, flushing and moderate increase in blood pressure. Side effects are generally temporary and end when the therapy is discontinued.

Dosage and Administration:

250 mcg IM. This may be repeated at 15 to 90 minute intervals on the basis of response up to a cumulative dose of 2 mg.

Onset of Action:

Peak serum concentrations occur 15 to 60 minutes after injection.

Half-life:

Less than 1 hour