Generic
Carbetocin
5 brands available in the market
At a glance
Carbetocin is a synthetic oxytocin analogue used for the prevention of uterine atony and excessive bleeding following caesarean section. It binds to oxytocin receptors on uterine smooth muscle, causing uterine contractions.
Description
Carbetocin is a drug used to control postpartum hemorrhage (bleeding after giving birth). It is an analogue of oxytocin, and its action is similar to that of oxytocin; it causes contraction of the uterus. Carbetocin binds to oxytocin receptors present on the smooth musculature of the uterus, resulting in rhythmic contractions of the uterus, increased frequency of existing contractions, and increased uterine tone. The oxytocin receptor content of the uterus is very low in the non-pregnant state, and increases during pregnancy, reaching a peak at the time of delivery.
Carbetocin is indicated for the prevention of uterine atony and postpartum hemorrhage following delivery by elective caesarean section under epidural or spinal anaesthesia.
Indications
- Prevention of uterine atony after caesarean section
- Prevention of excessive bleeding (postpartum hemorrhage) after caesarean section
Therapeutic class
Drugs acting on the Uterus
Pharmacological class
Oxytocin Analogue / Uterotonic Agent
Pharmacology
Carbetocin is a synthetic analogue of oxytocin reported to have a longer duration of action. It binds to oxytocin receptors on uterine smooth muscle, causing uterine contractions, which helps prevent uterine atony and postpartum hemorrhage. Carbetocin's longer duration of action makes it effective as a single dose compared to oxytocin.
Mechanism of action
Carbetocin binds to oxytocin receptors on the uterus, causing rhythmic uterine contractions, which constrict blood vessels and reduce uterine bleeding.
Dosage
Adults: A single dose of 100 mcg IV bolus (slowly over 1 minute) administered within 1 minute after delivery following caesarean section.
Children: Not intended for use in children.
Note: Single dose only. Administer only after the infant has been delivered by caesarean section under epidural or spinal anaesthesia.
Administration
For IV administration only. Administer as a slow IV bolus injection over 1 minute by a healthcare professional. Use immediately after opening the ampoule.
Missed dose
Hospital-only medicine. Administered by doctor or nurse as a single dose after delivery. Missed dose concept does not apply.
Side effects
Common (10-40% of patients): Nausea, vomiting, abdominal pain, pruritus (itching), increased body temperature, trembling, weakness.
Infrequent (1-5% of patients): Back pain, dizziness, metallic taste, anaemia, sweating, chest pain, dyspnoea, chills, tachycardia, anxiety, flushing, feeling of warmth, hypotension, headache.
Precautions & warnings
- If adequate uterine contraction is not achieved after a single dose, additional doses of oxytocin or ergometrine may be required.
- Monitor blood pressure in patients with eclampsia and pre-eclampsia for up to 8 hours.
- Do not repeat treatment for inadequate uterine contraction (use additional oxytocin/ergometrine instead).
- Use with caution in epilepsy, migraine, asthma, or any condition where rapid addition to extracellular water may be hazardous.
- Not recommended for use in elderly patients.
- Carbetocin is structurally related to oxytocin; hyponatremia may occur.
Contraindications
- Administration before delivery (for any reason)
- Cardiovascular disease (especially coronary artery disease, valvular heart disease, cardiomyopathy, heart failure)
- Hepatic or renal disease
- History of hypersensitivity to oxytocin or carbetocin
- Use in children
Drug interactions
No specific drug interactions have been reported. However, caution is advised with vasoconstrictors in conjunction with caudal block anaesthesia and cyclopropane anaesthesia.
Food interactions
No food-related restrictions (parenteral administration).
Use in pregnancy
Contraindicated during pregnancy (do not administer before delivery). Inappropriate use during pregnancy may cause oxytocin overdosage symptoms (uterine hyperstimulation, tetanic contractions, uterine rupture, foetal hypoxia, etc.).
Use in lactation
Small amounts of carbetocin cross from plasma into breast milk. The small amount ingested by the infant would not be expected to present a significant safety concern.
Pediatric use
Not intended for use in children.
Geriatric use
Not recommended for use in elderly patients.
Renal / hepatic impairment
Contraindicated in hepatic or renal disease.
Overdose effects
Overdosage can be expected to produce enhanced pharmacological effects associated with uterine hyperactivity and pain. Treatment: Symptomatic and supportive management.
Storage conditions
Store at 2-8°C. Do not freeze. Keep away from light. Once the ampoule has been opened, use immediately.
Chemical structure
Carbetocin (Synthetic Oxytocin Analogue)