Indications
Carbetocin is used to prevent heavy bleeding after childbirth (postpartum haemorrhage) caused by the womb not contracting properly (uterine atony). It is given straight after the baby is delivered, by caesarean section or by vaginal birth. It is a hospital medicine given by a doctor, nurse or midwife.
How It Works
Carbetocin is a long-acting man-made form of Oxytocin, the natural hormone that makes the womb contract. It attaches to oxytocin receptors in the womb muscle and causes strong, lasting contractions that squeeze the blood vessels where the placenta was attached, reducing bleeding. One dose works for longer than a dose of Oxytocin.
Dosage and Administration
Given as a single injection into a vein (slowly) or into a muscle by a health professional, as prescribed, immediately after delivery of the baby. Further doses are not usually given.
Interactions
Using Carbetocin together with Oxytocin or ergometrine-type medicines (such as Methylergometrine) can over-stimulate the womb and raise blood pressure. Some anaesthetics and medicines used to raise blood pressure may interact; the medical team will manage this.
Contraindications
Not used during pregnancy before the baby is born, or to start or speed up labour. Not used in women with severe high blood pressure or pre-eclampsia/eclampsia, serious heart disease, epilepsy, serious liver or kidney disease, or allergy to Carbetocin or Oxytocin.
Side Effects
- Nausea, vomiting, stomach pain
- Headache, dizziness, tremor
- Flushing, feeling warm, itching
- Low blood pressure, fast heartbeat
- Chest pain or shortness of breath (less common)
Tell the medical team at once about chest pain, severe headache, difficulty breathing, severe dizziness or heavy bleeding that continues, or signs of an allergic reaction such as rash or swelling.
Pregnancy and Lactation
Given only after the baby is born, never during pregnancy. Breastfeeding can continue; only very small amounts pass into breast milk and are not expected to affect the baby.
Precautions and Warnings
Used with care in women with migraine, asthma, heart or blood vessel disease, or conditions where fluid build-up would be dangerous. Women are monitored for bleeding, blood pressure and fluid balance after the injection.
Overdose
Overdose can cause excessive womb contractions, rupture of the womb, bleeding and water intoxication (low blood sodium). It is managed in hospital.
Therapeutic Class
Uterotonic; oxytocin analogue (hospital medicine).
Storage
Store as directed on the pack. Some products need a refrigerator at 2 to 8°C (do not freeze), while heat-stable forms can be kept below 30°C. Keep away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.