Carboprost is a synthetic analogue of prostaglandin F2α (PGF2α). It is a potent uterotonic agent primarily used in obstetrics and gynecology for the medical management of postpartum hemorrhage (PPH) and for second-trimester pregnancy termination. In the Indian context, it is a critical drug in emergency obstetric care protocols, especially in resource-limited settings where surgical interventions may not be immediately available.
Adult: For PPH: 125 mcg (0.125 mg) intramuscularly. May be repeated at intervals of 90 minutes to 4 hours. Maximum total dose: 1 mg (8 doses). For abortion: 250 mcg (0.25 mg) intramuscularly repeated at 1.5 to 3.5 hour intervals. Maximum total dose: 12 mg.
Note: Administer by deep intramuscular injection in the upper arm or gluteal region. Aspirate before injection to avoid intravascular administration. Do not administer intravenously. The vial must be stored refrigerated (2-8°C) and used immediately after warming to room temperature. Shake well before use.
Carboprost binds to the prostaglandin F (FP) receptor on myometrial cells. This binding activates Gq-protein coupled signaling, leading to increased intracellular calcium (Ca2+) concentration via phospholipase C (PLC) and inositol trisphosphate (IP3) pathway. The surge in calcium facilitates the interaction of actin and myosin, resulting in strong, sustained uterine contractions. It also causes vasoconstriction, which aids in hemostasis at the placental site.
Pregnancy: US FDA Pregnancy Category C. Used specifically for termination of pregnancy (12-20 weeks) and management of PPH after delivery. It is contraindicated in pregnancies where continuation is desired.
Driving: May cause dizziness, flushing, or chills. Patients should be advised not to drive or operate machinery until they know how the medication affects them. Typically administered in a hospital setting.
| Other Oxytocics (Oxytocin, Methylergometrine) | Potentiates uterotonic effect, increasing risk of uterine hyperstimulation or rupture. | Major |
| Non-Steroidal Anti-Inflammatory Drugs (NSAIDs: Ibuprofen, Diclofenac) | May antagonize the uterotonic effect of carboprost. | Moderate |
| Antihypertensives | Carboprost can cause hypertension, counteracting their effect. | Moderate |
| Bronchodilators (e.g., Salbutamol) | May be required to counteract carboprost-induced bronchospasm. | Moderate |
Same composition (Carboprost (125mcg)), different brands: