A prostaglandin injection for bleeding after birth
Carboprost
A prostaglandin injection used to control heavy bleeding after birth when first-line treatments have not been enough.
What is Carboprost?
Carboprost is a prostaglandin given by injection by maternity teams to stop heavy bleeding after birth (postpartum haemorrhage) when first-line medicines, such as oxytocin and ergometrine, have not controlled it. It works by making the womb contract firmly, which closes off the bleeding vessels. It is given in an emergency setting by experienced staff. It is avoided in women with significant asthma, because it can tighten the airways. The brand name is Hemabate.
Education and reference only. This is a plain-language guide to Carboprost — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Carboprost is a man-made prostaglandin used in maternity care to treat heavy bleeding after the birth of a baby. Most bleeding after birth is controlled by other medicines first; carboprost is used when those have not been enough. It is given as an injection into muscle (or sometimes directly into the womb muscle) by doctors and midwives in an emergency situation, and may be repeated if needed.
How it works
After birth, the womb normally contracts down to squeeze shut the blood vessels where the placenta was attached. If it does not contract well, heavy bleeding can follow. Carboprost is a powerful prostaglandin that makes the womb muscle contract strongly, clamping these vessels and reducing the bleeding. Because prostaglandins also act on other muscle, it can affect the airways and the gut, which explains some of its effects.
Company & origin
Originated / developed by: Generic (specialist supply).
A prostaglandin injection used by UK maternity teams to control heavy bleeding after birth when first-line treatments have not worked.
Practical use
How to take Carboprost
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by injection by maternity staff in an emergency; it is not something you take yourself.
- It may be repeated at intervals if bleeding continues, alongside other treatments.
- Tell the team beforehand, if you can, about any asthma or breathing problems, as this affects whether it can be used.
- Expect possible nausea, flushing, diarrhoea or a raised temperature soon after the injection.
- The team will monitor your bleeding, blood pressure and general condition closely throughout.
Weighing it up
Advantages & disadvantages of Carboprost
Advantages
- A powerful option for heavy bleeding after birth when first-line medicines have not worked.
- Acts quickly to make the womb contract and reduce dangerous blood loss.
- Can be repeated and combined with other emergency measures as needed.
Disadvantages
- Commonly causes nausea, vomiting, diarrhoea, flushing and a raised temperature.
- Can tighten the airways, so it must be avoided or used very cautiously in significant asthma.
- Is an emergency, hospital-only injection given by specialist staff.
Practical use
Good to know
Carboprost is an emergency, hospital-only treatment given by experienced maternity staff when bleeding after birth is not controlled by first-line measures. The most important caution is that it can tighten the airways, so it is avoided or used only with great care in women with significant asthma. It commonly causes nausea, vomiting, diarrhoea, flushing and a raised temperature, which are expected with its prostaglandin action. It may be repeated at intervals if bleeding continues, and other treatments or procedures are used alongside it as needed. Because it is given in an emergency, the team focuses on stopping the bleeding quickly and supporting the mother throughout.
Who should not take it / use with caution
- Women with significant asthma, because it can tighten the airways.
- Women with certain heart, lung, liver or kidney conditions, where the team will weigh the risks carefully.
- Anyone with a known allergy to it or for whom the maternity team judges it unsuitable.
Monitoring
- Close monitoring of bleeding, blood pressure, pulse and overall condition.
- Watching breathing, especially in anyone with a history of asthma.
- Reviewing the response and deciding whether repeat doses or other treatments are needed.
Side effects
- Nausea, vomiting and diarrhoea are common soon after the injection.
- Flushing, a raised temperature, shivering and headache can occur.
- Rarely, wheezing or breathing difficulty, especially in people prone to asthma.
Key interactions
- It adds to the effect of other medicines that make the womb contract, which is sometimes intended in an emergency.
- Care is taken in people on medicines for the heart or lungs, given its effects on those systems.
- The team reviews known allergies and conditions, as breathing problems are the main concern.
Available as: Injection given into muscle (or the womb muscle) by maternity staff.
Answers
Carboprost: frequently asked questions
What is carboprost used for?
It is used by maternity teams to control heavy bleeding after birth when first-line medicines, such as oxytocin and ergometrine, have not stopped it.
How does it stop the bleeding?
It makes the womb muscle contract firmly, which squeezes shut the blood vessels where the placenta was attached and reduces the bleeding.
Why is asthma a concern with it?
As a prostaglandin, it can tighten the airways, so it is avoided or used very cautiously in women with significant asthma.
Will it make me feel unwell?
It commonly causes nausea, vomiting, diarrhoea, flushing and a raised temperature. These are expected effects and the team will support you.
Is it given as a tablet?
No. It is an injection given by maternity staff in an emergency, and may be repeated at intervals if bleeding continues.
Authoritative sources
- BNF
- NICE CKS
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