Carboprost (15-methyl prostaglandin F2 alpha) is being administered for atonic postpartum hemorrhage at 250 mcg intramuscularly every 15 minutes. What is the maximum cumulative dose beyond which further administration should not be attempted?

• A 0.75 mg
• B 1 mg
• C 1.5 mg
• D 2 mg ✓

Explanation

The recommended regimen is 250 mcg IM every 15 minutes for a maximum of 8 doses, giving a cumulative ceiling of 2 mg. Beyond this, failure implies surgical or mechanical control is required, and repeated dosing mainly adds risks of bronchospasm and hypertension. Misoprostol's 800 mcg sublingual dose is a separate agent and should not be confused with this limit.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.