"Prostin": a drug name with many meanings

A physician ordered "Prostin" for a patient with uterine bleeding. The physician, who previously practiced in Europe, meant to order carboprost tromethamine, which is known as PROSTIN 15 in some European and Scandinavian countries. In the US, carboprost tromethamine is called HEMABATE. However, there are two other products in the US named Prostin. PROSTIN E2 (dinoprostone, prostaglandin E2) is a 20 mg vaginal suppository used for induction of labor, cervical ripening, postpartum hemorrhage, uterine atony, and as an abortifacient. Also, PROSTIN VR Pediatric (alprostadil, prostaglandin E1) is used to maintain patency of ductus arteriosus in neonates with congenital heart defects. Hemabate is available in 250 mcg/mL, 1 mL ampuls. Prostin VR Pediatric is available in 500 mcg ampuls of 1 mL, exactly double the amount available with Hemabate, adding to the potential for confusion. In the above case, pharmacy assumed that the patient received the wrong drug since they found an ampul of Prostin VR Pediatric missing from inventory, but none was ordered during the previous 24 hours. (Carboprost tromethamine is currently unavailable due to manufacturing problems). No adverse effects were reported. When we did a search using the term "prostin," we got "hits" on all of the above drugs plus another, PROSTIN F2 (dinoprost, prostaglandin F2 alpha), an abortifacient that was withdrawn from the US market in 1987 but is still available outside the US. To reduce confusion, these products should be ordered using both generic and brand name. "Pediatric" must be set up in the brand name field for Prostin VR. Pharmacists should also be aware of the patient's condition and indication for use of a prostaglandin. Below is a table of prostaglandin products found in a search using the term, "prostin."