Carbetocin (Intravenous)

Carbetocin is used to treat postpartum women who are at risk of hemorrhaging or bleeding after delivery.

Overview

If women experience excessive bleeding following labor, it can constitute a life-threatening emergency. In order to avoid this, medics must stop the bleeding as quickly as possible. If they are able to do so, it negates the need for blood transfusions and reduces the risk of fatalities occurring.

Carbetocin is used to reduce bleeding or hemorrhaging following labor and is predominantly used to treat women who have undergone a cesarean section. When a baby is delivered via caesarean section, there is a risk that the uterus may not contract quickly enough. Due to this, bleeding is more likely to occur.

By binding to the oxytocin receptors on the musculature of the uterus, Carbetocin causes the uterus to contract rhythmically. In addition to this, Carbetocin helps to increase the frequency of uterine contractions and improves uterine tone. As the number of oxytocin receptors increase during pregnancy, Carbetocin is able to take effect quickly.

Once the uterus begins to contract following the delivery, the bleeding is likely to lessen or stop completely. As a result, Carbetocin can be a life-saving treatment and can certainly prevent women from suffering additional complications after birth.

Although oxytocin is also used to achieve the same effects, many physicians prefer to use Carbetocin. As well as being extremely effective, Carbetocin is not subject to the same restrictive storage demands, which means that the drug can be used in various circumstances. In countries which may not have access to advanced storage technology, for example, Carbetocin can still be used safely.

Due to technological and medical advancements, labor is not as dangerous as it once was. Women still face various medical complications when giving birth, however, and it's vital that obstetricians have access to the right resources and treatments. By using appropriate medications, such as Carbetocin, physicians can ensure that the mother's life is saved following an emergency and that hemorrhages can be treated quickly and efficiently.

Conditions Treated

  • Postpartum uterine hemorrhaging/bleeding

Type of Medicine

  • Oxytocic
  • Anti-hemorrhagic
  • Uterine stimulant

Side Effects

Even when Carbetocin has its intended effects, patients may suffer from unwanted side-effects after the drug has been administered. Although side-effects can occur after treatment with Carbetocin, patients will not necessarily suffer any adverse effects at all. More common side-effects which are associated with Carbetocin are:

  • Abdominal pain
  • Nausea
  • Dizziness
  • Faintness
  • Vomiting
  • Feeling of warmth
  • Headache
  • Light-headedness
  • Itching skin
  • Trembling
  • Unusual tiredness or weakness

Although the following side-effects are less common, they may still occur when patients have been treated with Carbetocin:

  • Chest pain
  • Chills
  • Back pain
  • Fast heartbeat
  • Nervousness
  • Metallic taste
  • Pain
  • Pale skin
  • Sweating
  • Shortness of breath

If side-effects are particularly severe or prolonged, they may require medical intervention. As Carbetocin is typically administered in a clinical setting, doctors should be able to monitor the patient easily and treat any side-effects as they occur.

Dosage

Carbetocin is normally administered intravenously, which means that it is injected into the patient's vein in solution form. Delivering the medicine in this form means that will start to work quickly, with the drug taking effect in approximately two minutes. Although the medicine can also be delivered intra-muscularly, this is not the most common way of prescribing the medication. As speed is essential in the event of a life-threatening hemorrhage, delivering Carbetocin intravenously is normally the most appropriate form of treatment.

Typically, patients are given a dose of 100 micrograms (1mL), injected over one minute after the baby has been delivered.

Although this is a standard dose of Carbetocin, every patient is different and may, therefore, require a different dose or a different treatment regime. Physicians will assess the patient's condition before prescribing and administering a unique treatment plan, tailored to their needs.

Warnings

Currently, Carbetocin is not thought to interact with any other medications. As the medicine is similar to oxytocin, it may interact with drugs which are known to interact with oxytocin. There is a possibility that interactions may also occur with Cyclopropane or a caudal block anesthesia, if given with a vasoconstrictor.

Although Carbetocin is not thought to interact with any particular medications, it may worsen side-effects if it is administered to patients who are already taking the following medications:

  • Acebutolol
  • Aliskiren
  • Aldesleukin
  • Amifostine
  • Amiodarone
  • Amiloride
  • Amlodipine
  • Amobarbital
  • Amyl Nitrate
  • Amphotericin B
  • Apraclonide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Arotinolol
  • Azilsartan Medoxomil
  • Barbital
  • Barbexalcone
  • Barnidipine
  • Benazepril
  • Bepridil
  • Bendroflumethiazide
  • Betaxolol
  • Bortezomib
  • Bisoprolol
  • Bretylium
  • Bromocriptine
  • Brimonidine
  • Bumetanide
  • Bupivacaine
  • Candesartan Cilexetil
  • Canagliflozin
  • Captopril
  • Carboprost Tromethamine
  • Carteolol
  • Chlorothiazide
  • Carvedilol
  • Chlorthalidone
  • Chlorpromazine
  • Cilazapril
  • Clevidipine
  • Clinidipine
  • Clomipramine
  • Clofarabine
  • Clonidine
  • Conivaptan
  • Clozapine
  • Dapagliflozin
  • Desflurane
  • Diclofenamide
  • Dexmedetomidine
  • Diltiazem
  • Dinutuximab
  • Dinoprostone
  • Dipryidamole
  • Duloxetine
  • Doxazosin
  • Empagliflozin
  • Efonidipine
  • Enalapril
  • Eplerenone
  • Enalaprilat
  • Epoprostenol
  • Esmolol
  • Eprosartan
  • Etocrynic Acid
  • Felodipine
  • Fimasartan
  • Fenoldopam
  • Furosemide
  • Fosinopril
  • Guanfacine
  • Halothane
  • Hydralazine
  • Hexobarbital
  • Hydroflumethiazide
  • Hydrochlorothiazide
  • Imidapril
  • Iloprost
  • Imipramine
  • Indoramin
  • Indapamide
  • Irbesartan
  • Isoflurane
  • Isocarboxazid
  • Isosorbide Dinitrate
  • Isoxsuprine
  • Isosorbide Mononitrate
  • Isradipine
  • Labetalol
  • Larcanidipine
  • Lacidipine
  • Levobunolol
  • Levodopa
  • Levobupivacaine
  • Levosimendan
  • Lofexidine
  • Losartan
  • Lisinopril
  • Mannitol
  • Methazolamide
  • Mecamylamine
  • Methohexital
  • Methyldopa
  • Methyclothiazide
  • Methylphenobarbital
  • Metolazone
  • Metipranolol
  • Metoprolol
  • Minoxidil
  • Moexipril
  • Misoprostol
  • Morphine
  • Moxonidine
  • Nadolol
  • Nabilone
  • Nebivolol
  • Nicardipine
  • Nesiritide
  • Nifedipine
  • Nicorandil
  • Nilvadipine
  • Nisoldipine
  • Nimodipine
  • Nitrendipine
  • Nitoglycerin
  • Nitroprusside
  • Obinutuzumab
  • Oxprenolol
  • Olmesartan
  • Paclitaxel
  • Penbutolol
  • Papaverine
  • Pentobarbital
  • Phenelzine
  • Perindopril
  • Phenobarbital
  • Phenoxybenzamine
  • Pindolol
  • Phentolamine
  • Pipamperone
  • Prazosin
  • Pramipexole
  • Primidone
  • Propranolol
  • Propofol
  • Quinapril
  • Quetiapine
  • Rasagiline
  • Ramipril
  • Remifentanil
  • Riociguat
  • Reserpine
  • Risperidone
  • Ropivacaine
  • Ropinirole
  • Rotigotine
  • Sacubitril
  • Selegiline
  • Secobarbital
  • Sevoflurane
  • Sotalol
  • Sodium Nitrate
  • Spironolactone
  • Sufentanil
  • Streptokinase
  • Tamsulosin
  • Telmisartan
  • Thiamylal
  • Terazosin
  • Thiopental
  • Timolol
  • Tolazoline
  • Tizanidine
  • Torasemide
  • Tolcapone
  • Tranylcypromine
  • Trandolapril
  • Tretinoin
  • Triamterene
  • Verapamil
  • Valsartan

Patients should provide their obstetrician with a full list of any existing medications prior to their delivery date. This will ensure that medics can access the information while labor is ongoing.

If patients take any over-the-counter medications, vitamins or supplements once they have been discharged from hospital, they should consult a doctor or pharmacist.

If patients have been diagnosed with an existing heart or blood vessel disease, Carbetocin should be used with caution. As Carbetocin could worsen these conditions, physicians will need to determine whether the benefits of administering the drug outweigh the potential risks.

In rare circumstances, patients may develop an allergic reaction to Carbetocin. Any allergic reaction should be treated as an emergency. Regularly monitoring of the patient in a clinical setting will ensure that potential allergic reactions can be treated quickly. In addition to this, patients should inform their doctors of any allergies they have prior to their due date.

Currently, it is not known if treatment with Carbetocin affects infants when they are breastfed. Although it is suspected that Carbetocin can be transferred to the infant via breastmilk, one dose of the medicine is not thought to present a significant risk. If Carbetocin has been administered recently, mothers should seek medical advice before breastfeeding an infant.

Carbetocin should not be used prior to the delivery of a baby. If Carbetocin is administered to a pregnant woman, it can cause numerous adverse effects, such as cervical and vaginal lacerations, hyperstimulation of the uterus, hemorrhage, uteroplacental hypoperfusion, tumultuous labor, deceleration of the fetal heart rate, uterine rupture, hypercapnia, fetal hypoxia and/or death. Due to this, Carbetocin should only be administered to the patient following the delivery of the child.

Storage

As Carbetocin is administered as a solution, in a clinical setting, patients will not be required to store and take this medicine at home.

In order to ensure that the medication is safe and effective, it should be stored at a temperature lower than 30°. However, some manufacturers advise that the medicine is stored in a refrigerator, within a temperature range of 2°-8° (36°-46°). Due to this, physicians, nurses and medical professionals should follow the manufacturer's instructions when storing each dose of Carbetocin.

Once the medication has been opened, it should be prepared and used immediately.

Summary

If women experience postpartum bleeding or hemorrhaging, they are in a life-threatening situation. The loss of too much blood can have catastrophic consequences and could lead to death, if it is left untreated. Although physicians can administer blood transfusions in order to replace any blood which is lost, it is also essential that they treat the condition which is causing the bleeding to occur.

Carbetocin allows them to do this. Once the medicine has been administered, it will begin to have an effect on the uterus. By stimulating the uterus to contract at a regular rate, the bleeding will begin to reduce and cease. Treatment with Carbetocin will, therefore, stop hemorrhaging and excessive bleeding in patients who have just delivered a baby.

When patients are losing blood following labor, treatment needs to be quick in order to be effective. As Carbetocin is delivered intravenously, it will begin to resolve the issue within a matter of minutes.

Appropriate for use following a vaginal delivery or a caesarean section, Carbetocin can be used on a wide range of patients. Whilst some women may experience side-effects after treatment with Carbetocin, these are not normally serious or concerning. Due to this, Carbetocin is a popular choice of medication when treating postpartum bleeding and hemorrhaging.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
April 04, 2018
Content Source: