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Uterotonic (Prostaglandin) Pregnancy: Used in postpartum setting

Carboprost

Brand names: Hemabate

Adult dose

Dose: 250 micrograms IM every 15–90 minutes
Route: Deep IM
Frequency: Repeat every 15–90 minutes as needed
Max 8 doses (2mg total). Can be given intramyometrially by surgeon at Caesarean section (off-label).

Clinical pearls

  • Third-line uterotonic after oxytocin and ergometrine fail in PPH
  • ABSOLUTELY CONTRAINDICATED in asthma — can cause fatal bronchospasm
  • Pre-warm: comes refrigerated — allow to reach room temperature before injection
  • Part of the HAEMOSTASIS mnemonic for PPH management
  • Consider alongside tranexamic acid, balloon tamponade, and surgical intervention in refractory PPH

Contraindications

  • Asthma or severe bronchospasm
  • Active cardiac disease
  • Hepatic/renal/pulmonary disease

Side effects

  • Bronchospasm (SEVERE — avoid in asthma)
  • GI: nausea, vomiting, diarrhoea
  • Hypertension
  • Flushing
  • Fever
  • Chills

Interactions

  • Other uterotonics — additive effects
  • NSAIDs — theoretical reduction in prostaglandin effect

Monitoring

  • Respiratory rate and SpO2 (bronchospasm)
  • Blood pressure
  • Uterine tone
  • Blood loss

Reference: RCOG PPH Green-top Guideline; WOMAN trial. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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