• Miscellaneous Ob/Gyn conditions

Hemabate Generic Name & Formulations

General Description

Carboprost (as tromethamine salt) 250mcg/mL; soln for IM inj; contains benzyl alcohol.

Pharmacological Class


How Supplied

Ampules (1mL)—1, 10


Must be refrigerated at 2° to 8° C (36° to 46° F).


Generic Availability


Mechanism of Action

Carboprost tromethamine administered intramuscularly stimulates in the gravid uterus myometrial contractions similar to labor contractions at the end of a full term pregnancy. Whether or not these contractions result from a direct effect of carboprost on the myometrium has not been determined. Nonetheless, they evacuate the products of conception from the uterus in most cases. Postpartum, the resultant myometrial contractions provide hemostasis at the site of placentation.

Hemabate Indications


For aborting pregnancy between the 13th and 20th weeks of gestation in the following conditions related to second trimester abortion: 1) failure of expulsion of the fetus during the course of treatment by another method; 2) premature rupture of membranes in intrauterine methods with loss of drug and insufficient or absent uterine activity; 3) requirement of a repeat intrauterine instillation of drug for expulsion of the fetus; 4) inadvertent or spontaneous rupture of membranes in the presence of a previable fetus and absence of adequate activity for expulsion. For the treatment of postpartum hemorrhage due to uterine atony which has not responded to conventional methods of management.

Hemabate Dosage and Administration


Give by deep IM inj. Abortion: 250mcg; subsequent doses of 250mcg should be given at 1.5–3.5 hour intervals depending on uterine response. Optional test dose (100mcg) may be given initially. Dose may be increased to 500mcg if uterine contractility is judged to be inadequate after several doses of 250mcg. Max total dose: 12mg; continuous administration for >2 days not recommended. Refractory postpartum uterine bleeding: initially 250mcg once, may give additional doses at intervals of 15–90 mins if necessary. Max total dose: 2mg (8 doses).


Not established.

Hemabate Contraindications


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

Hemabate Boxed Warnings

Not Applicable

Hemabate Warnings/Precautions


Should only be used by trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities. Not indicated if fetus in utero has reached stage of viability. History of asthma, hypo- or hypertension, cardiovascular, renal, or hepatic disease, anemia, jaundice, diabetes, epilepsy. Compromised (scarred) uteri. Hypertension. Chorioamnionitis. Pregnancy.


Hemabate does not directly affect the fetoplacental unit. The possibility that the previable fetus aborted by Hemabate could exhibit transient life signs. Hemabate is not indicated if the fetus in utero has reached the stage of viability. Hemabate should not be considered a feticidal agent.

This product contains benzyl alcohol. Benzyl alcohol may be associated with a fatal "Gasping Syndrome" in premature infants.


  • Animal studies at high doses have shown that prostaglandins of the E and F series can induce proliferation of bone.
  • These effects have also been noted in newborn infants who have received prostaglandin E1 during prolonged treatment.
  • No evidence that short term use of Hemabate can cause similar bone effects.
  • Use Hemabate cautiously in patients with a history of asthma, hypo- or hypertension, cardiovascular, renal, or hepatic disease, anemia, jaundice, diabetes, epilepsy, or in those with compromised (scarred) uteri.


  • Abortion induced by Hemabate may be expected to be incomplete in about 20% of cases.
  • Always examine the cervix carefully and immediately post-abortion for possible cervical trauma.
  • Use of Hemabate is associated with transient pyrexia that may be due to its effect on hypothalamic thermoregulation.
  • Temperature elevations >2° F (1.1° C) were seen in approximately 1/8th of the patients who were given the recommended dosage regimen; however, returned to normal after therapy completion.

Postpartum Hemorrhage

  • Increased blood pressure.
    • In the postpartum hemorrhage series, 5/115 (4%) of patients had an increase of blood pressure reported as a side effect.
    • The degree of hypertension was moderate and it is not certain as to whether this was in fact due to a direct effect of Hemabate or a return to a status of pregnancy associated hypertension manifest by the correction of hypovolemic shock.
    • Cases reported did not require specific therapy for the elevated blood pressure.
  • Caution in those with chorioamnionitis.
    • In clinical trials with Hemabate, chorioamnionitis was identified as a complication contributing to postpartum uterine atony and hemorrhage in 8/115 (7%) of cases, 3 of which failed to respond to Hemabate.
    • This complication during labor may have an inhibitory effect on the uterine response to Hemabate similar to what has been reported for other oxytocic agents.

Pregnancy Considerations

Teratogenic Effects

Animal studies do not indicate that Hemabate is teratogenic, however, it has been shown to be embryotoxic in rats and rabbits and any dose which produces increased uterine tone could put the embryo or fetus at risk.

Pediatric Considerations

Safety and effectiveness in pediatric patients have not been established.

Hemabate Pharmacokinetics





Hemabate Interactions


Concomitant other oxytocic agents: not recommended.

Hemabate Adverse Reactions

Adverse Reactions

Vomiting, diarrhea, nausea, flushing, chills, headache, pain, breast tenderness; transient pyrexia (see full labeling re: PGEs induced pyrexia vs. endometritis pyrexia), others.

Adverse Reactions

Most common complications when used for abortion requiring additional treatment after discharge from the hospital, occurring in about one in every 50 patients were:

  • endometritis,
  • retained placental fragments,
  • excessive uterine bleeding.

Hemabate Clinical Trials

See Literature

Hemabate Note

Not Applicable

Hemabate Patient Counseling

See Literature