Carboprost
About
Carboprost belongs to the class of medication called 'oxytocic' or 'uterotonic', primarily used for the initiation or improvement of uterine contraction (antepartum) and producing uterine contraction during the third stage of labour (postpartum). Besides this, it also controls postpartum bleeding or haemorrhage after childbirth. Carboprost is also used for the medical termination of the pregnancy between the 13th to 20th week of pregnancy (second trimester of the pregnancy) after the first day of the last menses period.
Carboprost contains a synthetic prostaglandin (a chemical messenger) analogue ‘Carboprost’ with oxytocic properties. Carboprost stimulates uterine muscles and increases uterus contractions. It also increases the production of a natural substance called prostaglandins (PGs), increasing contractions and controlling postpartum bleeding. In addition, it is also used to produce an abortion by causing uterine contractions.
Carboprost administered by a doctor only in hospitals in which intensive care and surgical facilities are available. The most common side effects of Carboprost are nausea, vomiting, and headache in some cases. Most of these side effects of Carboprost do not require medical attention and gradually resolve over time. However, if the side effects are persistent, reach out to your doctor.
You should not receive Carboprost if you are allergic to it, have active pelvic inflammatory disease, have a lung disorder or breathing problem, or have heart disease, kidney disease or liver disease. Carboprost is not recommended to children below 18 years of age as safety and effectiveness have not been established. Do not do strenuous activities like running, heavy exercise or driving to avoid excessive bleeding. The doctor will also check with ultrasound if the absorption is complete, as no bleeding does not mean that abortion is complete. Although the incidence of cervical trauma is extremely small, the cervix (lower portion of the uterus) should always be carefully examined immediately post-abortion with Carboprost. Carboprost is a cold chain medicine, and so it has to be stored in the refrigerator between 2-8 degrees celsius else its efficacy might get lost. Do not store in the freezer or the fridge.
Uses of Carboprost
Medicinal Benefits
Carboprost contains ‘Carboprost’, a synthetic prostaglandin (a chemical messenger) analogue of PGF2α with oxytocic properties. It is used to treat severe bleeding after childbirth (postpartum). In addition to this, is also used to produce an abortion by causing uterine contractions. It is usually given between the 13th and 20th weeks (2nd trimester) of pregnancy. Carboprost stimulates uterine muscles and increases the contractions in the uterus. Also, it increases the production of prostaglandins, which further increases the contractions and hence control post-delivery bleeding. Carboprost is often used when another method of abortion has not completely emptied the uterus or when a pregnancy complication would cause the baby to be born too early to survive. Carboprost is more effective in preventing postpartum bleeding in high-risk patients undergoing cesarean delivery than oxytocin.
Directions for Use
Storage
Side Effects of Carboprost
- Nausea
- Vomiting
- Diarrhea
- Flushing (warmth, redness, or tingly feeling)
- Cough
- Headache
- Mild pelvic pain or menstrual-type cramps
- Endometriosis (tissue that lines the uterus grows somewhere else, such as the ovaries)
In-Depth Precautions and Warning
Drug Warnings
Do not take Carboprost if you are allergic to Carboprost or its ingredients. Increasing the dose of Carboprost can be harmful if your womb already has too strong contractions, any obstructions in the pathway that might prevent the delivery or if the baby is not receiving a sufficient oxygen supply. If you have been given prostaglandins, do not use Carboprost within 6 hours. If taken together, can increase the contractions. Carboprost should not be used for a prolonged time if the contractions do not increase or if you have severe pre-eclamptic toxaemia (high blood pressure, protein in the urine, and swelling) of blood or heart circulation problem. A professional should always administer Carboprost at a hospital, do not practice self-administration. It should also not be given as a rapid injection into a vein as it might cause hypotension (low blood pressure) or suddenly increased heart rate. Regular follow-up with the doctor is required for constant monitoring of abortion. If medical termination does not happen or becomes unsuccessful, it should be terminated surgically as it can lead to foetal defects. Your doctor will examine by ultrasonography to confirm if the abortion is complete. Confirmation of fetal death is imperative before administration when used for missed abortion or intrauterine fetal death. You should not receive Carboprost if you have an active pelvic inflammatory disease, a breathing disorder, heart disease, liver or kidney disease.
Drug Interactions
Drug-Drug Interaction: Carboprost interacts with other oxytocic agents (oxytocin), medicines used to treat diarrhoea (eluxadoline).
Drug-Food Interaction: Please tell your doctor about all the vitamins, herbs and supplements you are taking as Carboprost may interact with them to produce unpleasant side effects.
Drug-Disease Interaction: Carboprost should not be given to patients with acute pelvic inflammatory disease or active cardiac, pulmonary, renal or hepatic disease and asthma.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid or limit consumption of alcohol after taking Carboprost as it may cause serious side effects.
Pregnancy
safe if prescribedCarboprost is used to induce contractions in the uterus. Hence, it is considered safe to be used during pregnancy. Carboprost is also used for medical termination of pregnancy.
Breast Feeding
cautionIt is unknown whether Carboprost passes into breast milk or if it could harm a nursing baby. If you are breastfeeding, inform your doctor before taking Carboprost.
Driving
unsafePatients should refrain from driving until they know that Carboprost does not affect their ability to drive or use machines.
Liver
cautionIf you have a history or a pre-existing liver disease, inform your doctor before receiving this injection. Your doctor may adjust the dose or prescribe a suitable alternative based on your condition. Carboprost is contraindicated in patients with severe active hepatic disease.
Kidney
cautionCarboprost to be taken with caution, especially if you have a history of kidney diseases. Your doctor may adjust the dose or prescribe a suitable alternative based on your condition.
Children
unsafeCarboprost is not recommended for children under the age of 18. The safety and effectiveness of Carboprost have not been established in children due to limited testing of this drug on children by competent authorities worldwide.
Habit Forming
Diet & Lifestyle Advise
- Long walks can help to relieve stress, keep your body strong and help in easy delivery.
- Please take a little bit of Castrol oil as it is known to stimulate prostaglandin, which ripens the cervix and gets labour started.
- For some food like dates, raspberry tea leaves are known to ripen the cervix and get labour started.
- Acupressure also stimulates labour and helps in delivery.
- Keep your weight under control with a body mass index (BMI) of 19.5-24.9.
- Opt for a diet rich in whole grains, fruits, veggies and low-fat dairy products.
- Quitting smoking and not drinking alcohol is the best strategy to lower the risk of any complications.
- Avoid chronic stress and physical exercise like running, as it might increase vaginal bleeding.
- Monitor your blood pressure daily and if there is too much fluctuation, immediately contact your doctor.
- Get an ultrasound done to check if the abortion is done completely to avoid any unwanted complications.
- Try to include heart-healthy omega-3 fatty acid-containing food drinks in your daily diet. You can also use low-fat cooking oil like olive oil, soybean oil, canola oil and coconut oil to lower your elevated blood pressure.
Special Advise
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Carboprost when given for used to treat severe bleeding after childbirth (postpartum), it must be administered only under medical supervision in a hospital.
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Get an ultrasound done to check whether medical abortion is done completely to avoid any unwanted complications.
Patients Concern
Disease/Condition Glossary
Postpartum haemorrhage: It is heavy bleeding after the birth of the baby. Losing lots of blood quickly can cause a severe drop in blood pressure and may lead to shock and death if not treated. The common cause of postpartum haemorrhage is when the uterus does not contract enough after delivery. Symptoms include vaginal bleeding that doesn't slow or stop.
Medical abortion: Medical termination of pregnancy (MTP) or medical abortion is using abortion pills to terminate a pregnancy. MTP is feasible only up to 9 weeks of pregnancy, and after that, surgical termination takes over. MTP is one of the safest methods of terminating an unwanted pregnancy. You should be mentally prepared for all the risks a surgical absorption could lead to, like incomplete abortion, heavy and prolonged bleeding (may last up to 30 days), fever, digestive system discomfort fever. Also, if the medication does not work, it can lead to an unwanted ongoing pregnancy, leading to fetal defects. So, to avoid complications, keep in regular touch with your doctor and do as advised.
FAQs
Carboprost contains carboprost that stimulates contraction of the uterine muscles, helping to control post-delivery bleeding.
If you have a previous premature delivery or a c-section, or cervical surgery, please inform your doctor before starting Carboprost. Also, mention a detailed medical history to your doctor to avoid complications.
No, Carboprost is not known to affect any future chances of fertility. Carboprost is used for medical abortion of pregnancy.
You should not receive Carboprost, if you have a pelvic inflammatory disease, breathing disorder, heart fitted with an artificial valve, heart diseases like high blood pressure or high blood cholesterol levels (increased fat in your blood), have asthma, have blood clot problems, have a bleeding disorder, have liver or kidney disease, have anaemia (low haemoglobin) or otherwise malnourished. Taking Carboprost in these conditions can cause life-threatening conditions in an individual. Please inform your doctor, your doctor will decide whether to give Carboprost.
After taking Carboprost, you may or may not experience vaginal bleeding, which is not an indication of complete abortion. Your doctor will examine by ultrasonography to confirm if the abortion is complete.
The most common side effects of Carboprost include nausea, vomiting, headache, diarrhoea, and increased or decreased blood pressure. You might also feel increased uterine contractions for some time, but these are manageable under medical supervision.
