Carboprost Tromethamine

WARNINGS Carboprost tromethamine injection Sterile Solution (carboprost tromethamine), like other potent oxytocic agents, should be used only with strict adherence to recommended dosages. Carboprost tromethamine injection should be used by medically trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities. Carboprost tromethamine does not appear to directly affect the fetoplacental unit. Therefore, the possibility does exist that the previable fetus aborted by Carboprost tromethamine could exhibit transient life signs. Carboprost tromethamine is not indicated if the fetus in utero has reached the stage of viability. Carboprost tromethamine injection should not be considered a feticidal agent. Evidence from animal studies has suggested that certain other prostaglandins have some teratogenic potential. Although these studies do not indicate that Carboprost tromethamine injection is teratogenic, any pregnancy termination with Carboprost tromethamine injection that fails should be completed by some other means. This product contains benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants.

<table width="100%"><col width="100%" align="left" valign="top"/><tbody><tr><td styleCode="Lrule Rrule"><content styleCode="bold">WARNINGS</content></td></tr><tr><td styleCode="Lrule Rrule">Carboprost tromethamine injection Sterile Solution (carboprost tromethamine), like other potent oxytocic agents, should be used only with strict adherence to recommended dosages.</td></tr><tr><td styleCode="Lrule Rrule">Carboprost tromethamine injection should be used by medically trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities.</td></tr></tbody></table>

ADVERSE REACTIONS The adverse effects of Carboprost tromethamine Sterile Solution are generally transient and reversible when therapy ends. The most frequent adverse reactions observed are related to its contractile effect on smooth muscle. In patients studied, approximately two-thirds experienced vomiting and diarrhea, approximately one-third had nausea, one-eighth had a temperature increase greater than 2°F, and one- fourteenth experienced flushing. The pretreatment or concurrent administration of antiemetic and antidiarrheal drugs decreases considerably the very high incidence of gastrointestinal effects common with all prostaglandins used for abortion. Their use should be considered an integral part of the management of patients undergoing abortion with carboprost tromethamine injection. Of those patients experiencing a temperature elevation, approximately one-sixteenth had a clinical diagnosis of endometritis. The remaining temperature elevations returned to normal within several hours after the last injection. Adverse effects observed during the use of carboprost tromethamine injection for abortion and for hemorrhage, not all of which are clearly drug related, in decreasing order of frequency include: Vomiting Nervousness Diarrhea Nosebleed Nausea Sleep disorders Flushing or hot flashes Dyspnea Chills or shivering Tightness in chest Coughing Wheezing Headaches Posterior cervical Endometritis perforation Hiccough Weakness Dysmenorrhea-like Diaphoresis pain Dizziness Paresthesia Blurred vision Backache Epigastric pain Muscular pain Excessive thirst Breast tenderness Twitching eyelids Eye pain Gagging, retching Drowsiness Dry throat Dystonia Sensation of choking Asthma Thyroid storm Injection site pain Syncope Tinnitus Palpitations Vertigo Rash Vaso-vagal syndrome Upper respiratory Dryness of mouth infection Hyperventilation Leg cramps Respiratory distress Perforated uterus Hematemesis Anxiety Taste alterations Chest pain Urinary tract infection Retained placental Septic shock fragment Torticollis Shortness of breath Lethargy Fullness of throat Hypertension Uterine sacculation Tachycardia Faintness, light- Pulmonary edema headedness Endometritis from Uterine rupture IUCD The most common complications when Carboprost tromethamine injection was utilized for abortion requiring additional treatment after discharge from the hospital were endometritis, retained placental fragments, and excessive uterine bleeding, occurring in about one in every 50 patients. Post-marketing experience Hypersensitivity reactions (e.g. Anaphylactic reaction, Anaphylactic shock, Anaphylactoid reaction, Angioedema).

<table width="100%" styleCode="Noautorules"><col width="20%" align="left" valign="top"/><col width="30%" align="left" valign="top"/><col width="30%" align="left" valign="top"/><col width="20%" align="left" valign="top"/><tbody><tr><td/><td>Vomiting</td><td>Nervousness</td><td/></tr><tr><td/><td>Diarrhea</td><td>Nosebleed</td><td/></tr><tr><td/><td>Nausea</td><td>Sleep disorders</td><td/></tr><tr><td/><td>Flushing or hot &#xFB02;ashes</td><td>Dyspnea</td><td/></tr><tr><td/><td>Chills or shivering</td><td>Tightness in chest</td><td/></tr><tr><td/><td>Coughing</td><td>Wheezing</td><td/></tr><tr><td/><td>Headaches</td><td>Posterior cervical</td><td/></tr><tr><td/><td>Endometritis</td><td> perforation</td><td/></tr><tr><td/><td>Hiccough</td><td>Weakness</td><td/></tr><tr><td/><td>Dysmenorrhea-like</td><td>Diaphoresis</td><td/></tr><tr><td/><td> pain</td><td>Dizziness</td><td/></tr><tr><td/><td>Paresthesia</td><td>Blurred vision</td><td/></tr><tr><td/><td>Backache</td><td>Epigastric pain</td><td/></tr><tr><td/><td>Muscular pain</td><td>Excessive thirst</td><td/></tr><tr><td/><td>Breast tenderness</td><td>Twitching eyelids</td><td/></tr><tr><td/><td>Eye pain</td><td>Gagging, retching</td><td/></tr><tr><td/><td>Drowsiness</td><td>Dry throat</td><td/></tr><tr><td/><td>Dystonia</td><td>Sensation of choking</td><td/></tr><tr><td/><td>Asthma</td><td>Thyroid storm</td><td/></tr><tr><td/><td>Injection site pain</td><td>Syncope</td><td/></tr><tr><td/><td>Tinnitus</td><td>Palpitations</td><td/></tr><tr><td/><td>Vertigo</td><td>Rash</td><td/></tr><tr><td/><td>Vaso-vagal syndrome</td><td>Upper respiratory</td><td/></tr><tr><td/><td>Dryness of mouth</td><td> infection</td><td/></tr><tr><td/><td>Hyperventilation</td><td>Leg cramps</td><td/></tr><tr><td/><td>Respiratory distress</td><td>Perforated uterus</td><td/></tr><tr><td/><td>Hematemesis</td><td>Anxiety</td><td/></tr><tr><td/><td>Taste alterations</td><td>Chest pain</td><td/></tr><tr><td/><td>Urinary tract infection</td><td>Retained placental</td><td/></tr><tr><td/><td>Septic shock</td><td> fragment</td><td/></tr><tr><td/><td>Torticollis</td><td>Shortness of breath</td><td/></tr><tr><td/><td>Lethargy</td><td>Fullness of throat</td><td/></tr><tr><td/><td>Hypertension</td><td>Uterine sacculation</td><td/></tr><tr><td/><td>Tachycardia</td><td>Faintness, light-</td><td/></tr><tr><td/><td>Pulmonary edema</td><td> headedness</td><td/></tr><tr><td/><td>Endometritis from</td><td>Uterine rupture</td><td/></tr><tr><td/><td> IUCD</td><td/><td/></tr></tbody></table>