carboprost tromethamine: clinical use

Prescribing considerations

• Restrict use to medically supported specialist obstetric units.
• Do not use for induction of labour or administer intravenously.
• Assess respiratory and cardiovascular risk carefully, particularly with an asthma history or cardiopulmonary disease.
• Use caution with hypo- or hypertension, glaucoma or raised intraocular pressure, anaemia, jaundice, diabetes, epilepsy or a scarred uterus.
• Antiemetic and antidiarrhoeal management may reduce frequent gastrointestinal effects.

Contraindications and cautions

• Hypersensitivity to carboprost tromethamine or an excipient
• Acute pelvic inflammatory disease
• Known active cardiac, pulmonary, renal or hepatic disease
• Pregnancy

Monitoring

• Ongoing blood loss and uterine response
• Blood pressure, pulse and overall haemodynamic condition
• Respiratory status, particularly with asthma or cardiopulmonary problems
• Oxygenation with pre-existing cardiopulmonary problems; supplementary oxygen may be required
• Temperature and gastrointestinal adverse effects

Clinical pharmacology

A synthetic 15-methyl prostaglandin F2α analogue that stimulates myometrial contraction and promotes haemostasis at the placental site. The methyl group delays enzymatic inactivation, giving a more prolonged action than dinoprost.

Formulation and product differences

• The product is a colourless aqueous solution in glass ampoules for deep intramuscular injection.
• It contains benzyl alcohol and is considered essentially sodium-free.
• It requires refrigerated storage and visual inspection before administration.