Carboprost

How it works

It stimulates prostaglandin receptors on the myometrium to produce strong, sustained uterine contractions that compress bleeding vessels.

Prescribing in practice

• It is contraindicated in asthma because it can cause bronchospasm, and should be used with caution where there is cardiac, pulmonary, hepatic, or renal disease.
• It is a second-line agent for atonic postpartum haemorrhage, given by deep intramuscular injection (or directly into the myometrium) and repeated at intervals if needed up to a maximum number of doses.
• Common adverse effects include nausea, vomiting, diarrhoea, flushing, and pyrexia.

Monitoring

Monitor uterine tone, blood loss, blood pressure, temperature, and respiratory status during use.

Counselling the patient

• Explain that this injection is given to help control heavy bleeding after birth when other medicines have not worked.
• Side effects such as nausea, diarrhoea, flushing, and a raised temperature are common and usually short-lived.
• It is administered and monitored by the maternity team.

Evidence & guidelines

Prostaglandin uterotonics such as carboprost are recognised in NICE guidance as an option for refractory atonic postpartum haemorrhage.