Carbetocin
Use Instructions, Contraindications & Safety Information
Contraindications – When Carbetocin Should Not Be Used
- ▸ Carbetocin is strictly contraindicated before and during pregnancy .
- ▸ Use in elderly patients is not recommended.
- ▸ Carbetocin should not be used in children .
(Please refer to the complete prescribing information for full contraindication details.)
Important Warnings & Precautions
Inadequate Uterine Contraction
In some patients, a single dose of carbetocin may result in insufficient uterine contraction. In such cases, ergometrine may be administered as additional therapy under medical supervision.
Persistent Postpartum Bleeding
If bleeding continues, healthcare professionals should exclude:
- ▸ Retained placental fragments
- ▸ Coagulation disorders
- ▸ Trauma to the birth canal
Although no confirmed association exists, theoretical risk of placental retention may occur if carbetocin is administered before placental delivery.
Use in Pregnancy & Lactation
Carbetocin must not be used before delivery or during pregnancy .
Breastfeeding
- ▸ Trace amounts may appear in breast milk following a 70 µg intramuscular dose.
- ▸ Milk-to-plasma exposure ratio is approximately 2–3% , with milk concentrations about 50 times lower than plasma.
Due to rapid enzymatic breakdown in the infant's gastrointestinal tract, these trace amounts are considered clinically safe.
Effect on Milk Let-Down
- ▸ Unlike oxytocin, carbetocin does not consistently stimulate milk ejection.
- ▸ Clinical studies show normal milk flow in women receiving 70 µg intramuscularly.
Use in Children & Elderly Patients
- ▸ Children: Not recommended.
- ▸ Elderly: Not advised due to insufficient safety data.
Drug Interactions
No specific drug interactions have been conclusively identified. However, due to structural similarity to oxytocin, comparable interactions may occur.
Severe hypertension has been reported when oxytocin is administered 3–4 hours after prophylactic vasoconstrictors used during sacral block anesthesia.
Cyclopropane anesthesia may alter circulatory responses and could theoretically affect carbetocin, leading to hypotension or unexpected cardiovascular effects.