Carbestop

Indications

Carboprost is used in hospital to treat heavy bleeding after childbirth (postpartum haemorrhage) caused by the womb not contracting well, when usual treatments such as Oxytocin have not worked. It is also used in some countries to end a pregnancy in the second trimester under strict medical care.

How It Works

Carboprost is a man-made form of a natural prostaglandin (a hormone-like substance). It makes the muscle of the womb contract strongly. After delivery, these contractions squeeze the blood vessels in the womb wall and reduce bleeding.

Dosage and Administration

Carboprost is given as an injection into a muscle by a doctor or midwife in hospital. The dose, how often it is repeated and the maximum total are decided by the doctor according to the response and the situation. It is always given as prescribed, with close monitoring of bleeding, blood pressure, breathing and temperature.

Interactions

• Oxytocin and other medicines that make the womb contract can add to its effect; doctors adjust them carefully.
• Other prostaglandins, such as Misoprostol or Dinoprostone, should be combined only under specialist care.

Contraindications

• Allergy to Carboprost.
• Acute pelvic inflammatory disease.
• Active heart, lung, kidney or liver disease.
• Asthma is a strong reason for caution, as it can cause narrowing of the airways.

Side Effects

Common side effects include vomiting, diarrhoea, nausea, fever, chills, flushing and headache. Some women have a rise in blood pressure, breathing difficulty or wheezing, especially those with asthma. Rarely, low oxygen levels, fluid in the lungs or a womb tear can occur.

Tell the doctor or nurse at once if you have difficulty breathing, wheezing, chest pain, a severe headache, blurred vision or continuing heavy bleeding.

Pregnancy and Lactation

Carboprost makes the womb contract and must never be used during a pregnancy that is to continue. Only small amounts are expected in breast milk after use for bleeding after birth, and breastfeeding can usually continue; follow your doctor's advice.

Precautions and Warnings

• Used only in hospital by trained staff, with monitoring and emergency care available.
• Tell the doctor if you have asthma, high or low blood pressure, heart disease, diabetes, epilepsy, anaemia, jaundice or a scar on the womb.
• Fever caused by the medicine must be told apart from infection.

Overdose

An overdose is unlikely as it is given by health professionals. Too much can cause very strong womb contractions, severe vomiting and diarrhoea, and breathing problems. Treatment is supportive in hospital.

Therapeutic Class

Uterotonic (oxytocic) agent; prostaglandin F2-alpha analogue.

Storage

Hospital item: store in a refrigerator at 2 to 8°C, do not freeze, and keep in the carton to protect from light, as directed on the pack.