carboprost tromethamine (Rx)

Brand and Other Names:Hemabate
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 250mcg/mL
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Abortion

Initial: 250 mcg IM; THEN repeat PRN q1.5-3.5hr OR

An initial, optional test dose of 100 mcg IM; THEN increase dose to 500 mcg if response is inadequate with 250 mcg doses

No more than 1200 mcg total dose or 2 days of continuous administration

Refractory Postpartum Uterine Bleeding

Initial 250 mcg IM, repeat PRN q15-90min

No more than 2000 mcg or 8 doses

Not applicable

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Interactions

Interaction Checker

and carboprost tromethamine

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Effects due to increased smooth muscle contractility most common

            Nausea (1/3 patients), Vomiting (~2/3 patients)

            Diarrhea (~2/3 patients)

            Nervousness

            Epistaxis

            Sleep disorder

            Hyperthermia

            Flushing

            Asthma

            Wheezing

            Coughing

            Chest pain

            Flushing

            Hypertension

            Syncope

            Palpation

            Tachycardia

            Chest tightness

            Anxiety

            Chills/shivering

            Dizziness

            Drowsiness

            Dystonia

            Faintness

            Headache

            Lethargy

            Lightheadedness

            Nervousness

            Sleep disturbance

            Temperature elevation

            Vasovagal syndrome

            Vertigo

            Rash

            Breast tenderness

            Dysmenorrhea-like pain

            Endometritis

            Hot flashes

            Thyroid storm

            Gagging/retching

            Drowsiness

            Dry throat

            Choking sensation

            Thirst

            Taste alterations

            Perforated uterus

            Posterior cervical perforation

            Urinary tract infection

            Uterine bleeding (excessive)

            Uterine rupture

            Uterine sacculation

            Local: injection site pain

            Backache

            Leg cramps

            Muscular pain

            Parethesia

            Torticollis

            Weakness

            Blurred vision

            Eye pain

            Eyelid twitching

            Tinnitus

            Cough

            Bronchospasm

            Dyspnea

            Hyperventilation

            Pulmonary edema

            Respiratory distress

            Upper respiratory tract infection

            Wheezing

            Diaphoresis

            Hiccups

            Retained placental fragment

            Septic shock

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            Warnings

            Black Box Warning

            Potent oxytocic agent; use strict aderence to recommended dosing

            Only medically-trained personnel should administer the product in a hospital setting that can provide immediate care and acute surgical facilities

            Contraindications

            Hypersensitivity

            Acute pelvic inflammatory disease

            Active cardiac, pulmonary, renal or hepatic disease

            Cautions

            History of glaucoma or raised IOP

            Asthma, hypertension/hypotension, cardiovascular disease

            Transient fever observed with treatment possibly as a result of carboprost's effect on hypothalamic thermoregulation

            Caution in patients with anemia, jaundice, renal impairment, hepatic impairment diabetes or epilepsy

            To decrease GI side effects pretreatment or concomitant use with antiemetic and antidiarrheal agents recommended

            Not for IV

            Rare cases of cardiovascular collapse reported with prostaglandins

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Excretion in milk unknown

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Inhibits or stimulates smooth muscle contraction, which results in expulsion of the products of conception and is used to induce abortion between 13-20 weeks of pregnancy; inhibits release of norepinephrine or modulates its effects at neuroeffector sites

            Pharmacokinetics

            Peak plasma time: 20-30 min

            Concentration: 1-1.6 ng/mL

            Half-life: 3 hr

            Protein bound: None

            Excretion: Urine

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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