Caboprost

Description

Caboprost Injection: Clinical Information

Caboprost Injection is indicated for:

• Pregnancy termination in the second trimester (abortion).
• Management of postpartum uterine bleeding.

Dosage and Administration (Adults)

Intramuscular Administration Only

• Pregnancy Termination in the 2nd Trimester / Abortion:
  • Initial Dose: 250 micrograms. A test dose of 100 micrograms can be given initially.
  • Subsequent Doses: May be repeated every 1.5 to 3.5 hours, depending on the uterine response. The dose can be increased to 500 micrograms if uterine contractility is inadequate.
  • Maximum Dose: The total dose should not exceed 12 mg.
  • Maximum Duration: Treatment should not exceed 2 days.
• Postpartum Haemorrhage:
  • Initial Dose: 250 micrograms administered as a deep intramuscular injection.
  • Subsequent Doses: May be repeated every 15-90 minutes.
  • Maximum Dose: The total dose should not exceed 2 mg.

Contraindications

Caboprost Injection is contraindicated in patients with:

• Acute pelvic inflammatory disease.
• Active cardiac, pulmonary, renal, or hepatic disease.

Precautions

• Use with caution in patients with a history of glaucoma or raised intraocular pressure.
• Exercise caution in patients with asthma, hypertension/hypotension, or cardiovascular disease.
• Transient fever may occur, possibly due to carboprost’s effect on hypothalamic thermoregulation.
• Caution is advised in patients with anemia, jaundice, renal impairment, hepatic impairment, diabetes, or epilepsy.
• To minimize gastrointestinal side effects, pre-treatment or concomitant use with antiemetic and antidiarrheal agents is recommended.
• Not for intravenous (IV) administration.
• Rare cases of cardiovascular collapse have been reported with prostaglandins.
• Lactation: It is unknown whether carboprost is excreted in breast milk.

Interactions

• May potentiate the effect of other oxytocic agents.

Adverse Effects

Side effects of Carboprost can include:

• Gastrointestinal: Nausea (in about 1/3 of patients), vomiting, and diarrhea (in about 2/3 of patients each).
• General: Nervousness, epistaxis (nosebleed), sleep disorder, hyperthermia (fever), flushing, asthma, wheezing, coughing, chest pain, hypertension, syncope (fainting), palpitation, tachycardia (rapid heart rate), chest tightness, anxiety, chills/shivering, dizziness, drowsiness, dystonia, faintness, headache, lethargy, lightheadedness, vertigo.
• Dermatologic: Rash.
• Reproductive: Breast tenderness, dysmenorrhea-like pain, hot flashes, excessive uterine bleeding.
• Local: Pain at the injection site.
• Musculoskeletal: Backache, leg cramps, muscular pain, paresthesia.
• Sensory: Blurred vision, eye pain, eyelid twitching, tinnitus (ringing in ears).
• Respiratory: Bronchospasm, dyspnea (shortness of breath), hiccups.
• Other: Dry throat, taste alterations.

Mechanism of Action

Carboprost is a synthetic analogue of naturally occurring prostaglandin F2$\alpha$. It stimulates uterine contractility, leading to the expulsion of the products of conception. It is also used to induce abortion between 13-20 weeks of pregnancy. Additionally, it produces myometrial contractions responsible for placental haemostasis, making it effective in controlling postpartum haemorrhage.

Note: Caboprost 250 µG (1 ML) Injection is manufactured by Neon Laboratories Ltd. Its generic name is Carboprost. Caboprost is available in Nepal. This information from the Farmaco Nepal drug index is for informational purposes only and is not intended for diagnosis, medical advice, or treatment; neither is it a substitute for the exercise of professional judgment.