Carboprost

It is an oxytotic, containing the tromethamine salt of naturally occuring prostaglandin. It is highly effective in arresting intractable atonic post-partum haemorrhage. When administered, stimulates in the gravid uterus, resulting in myometrial contractions similiar to labour contractions at the end of full term pregnancy leading to evacuation of conception from the uterus.

Indications

Post partum haemorrhage, espeially due to uterine atony. Cessation of life threatening bleeding. Control of PPH. M.T.P. between 13th & 20th wks. Missed abortion, Intrauterine foetal death.

Dosage

Refractory post partum haemorrhage : Initially 250 mcg deep i.m. if required repeat after 15 to 90 mins. M.T.P. : 250 mcg deep i.m. initially with tuberculin syringe followed by 250 mcg after 2-3 hrs. Max: 12 mg & not more than 2 days.

Contra-Indications

Hypersensitivity. Active pelvic inflammatory disease. Cardiac, pulmonary, renal or hepatic disease.

Special Precautions

Induced abortion may be expected to be incomplete. Examine cervix after abortion for cervical trauma. Not recommended in the presence of choriamionitis, recourse to surgery may be considered. In patients with compromised (scared) uterus.

Side Effects

Vomiting, diarrhoea, nausea, temperature rise, flushing.

Drug Interactions

Enhances action of oxytocin. Incresed risk of side effects when used with antiemetics and antidiarrhoeals.