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Asthma: Postpartum hemorrhage treatment

The use of carboprost (Hemabate) should be avoided in patients with asthma. As stated in the drug information packaging:

In patients with a history of asthma, hypo- or hypertension, cardiovascular, renal, or hepatic disease, anemia, jaundice, diabetes, or epilepsy, Hemabate should be used cautiously.

There have since been a few case reports of bronchospasm associated with the use of Carboprost in both Asthmatic and non-Asthmatic patients (2,3). With this added information, and given that there are other readily available pharmaceutical options for the treatment of postpartum hemorrhage including Oxytocin, Misoprostol, and Methergine, the general consensus is that use of Carboprost in the asthmatic patient should be avoided when at all possible.

References

  1. D M Cooley, B Glosten, J R Roberts, P D Eppes, R B Barnes Bronchospasm after intramuscular 15-methyl prostaglandin F2 alpha and endotracheal intubation in a nonasthmatic patient. Anesth. Analg.: 1991, 73(1);87-9 PubMed Link
  2. C R Harber, D M Levy, S Chidambaram, M B Macpherson Life-threatening bronchospasm after intramuscular carboprost for postpartum haemorrhage. BJOG: 2007, 114(3);366-8 PubMed Link

Other References

  1. MATERIAL SAFETY DATA SHEET: Carboprost Tromethamine Sterile Solution, www.pfizer.com, Accessed 2/27/15. Link