Hemabate (Carboprost)

Hemabate is indicated for the management of obstetric conditions that involve insufficient uterine contraction.

• Treatment of postpartum hemorrhage due to uterine atony.
• Control of bleeding after cesarean section when uterine tone is inadequate.
• Management of retained placenta when uterine contraction is required.
• Adjunct therapy for severe primary postpartum hemorrhage unresponsive to oxytocin.
• Prevention of excessive bleeding during manual removal of the placenta.
• Use in cases of uterine inversion where rapid contraction is needed.

Side effects of Hemabate are related to its stimulation of uterine smooth muscle and systemic prostaglandin activity, and they can range from mild gastrointestinal symptoms to serious hypersensitivity reactions.

Common

• Abdominal cramping or uterine pain, often transient.
• Diarrhea or loose stools, sometimes accompanied by abdominal discomfort.
• Nausea, vomiting, or loss of appetite.
• Fever, chills, or mild headache.
• Injection site pain or erythema.

Serious

• Severe allergic reaction (anaphylaxis) with rash, swelling, or hypotension.
• Bronchospasm or respiratory distress, particularly in patients with asthma.
• Cardiovascular effects such as hypertension, tachycardia, or arrhythmia.
• Uterine rupture in cases of excessive dosing.

When prescribing Hemabate, clinicians should evaluate patient history and monitor for conditions that may increase the risk of adverse reactions.

• Contraindicated in patients with known hypersensitivity to carboprost or other prostaglandin analogs.
• Use with caution in individuals with asthma or a history of bronchospasm.
• Avoid in patients with active gastrointestinal bleeding or ulcer disease.
• Caution in patients with cardiovascular disease, hypertension, or arrhythmias.
• Monitor uterine tone and bleeding closely after administration.
• Consider dose adjustment in patients with severe liver impairment.

Hemabate may interact with other medications that affect uterine contractility, prostaglandin pathways, or respiratory function.

Avoid

• Concurrent use with other uterotonic agents (e.g., oxytocin, misoprostol) may cause excessive uterine contraction.
• Co‑administration with non‑steroidal anti‑inflammatory drugs (NSAIDs) can increase gastrointestinal irritation.
• Use with beta‑agonist bronchodilators may reduce the risk of bronchospasm but requires monitoring.

Use with caution

• Caution when combined with antihypertensive agents, as Hemabate may cause transient blood pressure changes.
• Use with caution in patients receiving anesthetic agents that depress respiration, due to potential bronchospasm.
• Caution with drugs that prolong the QT interval, as prostaglandin effects may affect cardiac rhythm.