PABAL 100mcg Injection/Solution for

What is PABAL 100mcg

PABAL 100mcg is a sterile injectable solution containing Carbetocin, a synthetic analog of the natural hormone oxytocin. It is primarily used in obstetrics to prevent postpartum hemorrhage (PPH) following childbirth. PPH is a serious condition characterized by excessive bleeding after delivery, which can be life-threatening if not managed promptly.

• Generic Name: Carbetocin
• Formulation: Injection solution, typically supplied as 1ml ampoules at 100 micrograms per ampoule.
• Therapeutic Use: Used mainly as a uterotonic agent to promote uterine contractions after delivery to reduce the risk of bleeding.
• Indications: Prevention of uterine atony and postpartum hemorrhage after vaginal or cesarean delivery.
• Advantages: Longer duration of action than natural oxytocin, allowing for more sustained uterine contraction with a single dose.
• Clinical Importance: Recommended by many obstetric guidelines worldwide as part of active management of the third stage of labor.

Overall, PABAL 100mcg is a vital medicine in modern obstetrics, helping to improve maternal outcomes by minimizing bleeding-related complications after childbirth.

How to use PABAL 100mcg

Proper administration of PABAL 100mcg is crucial for its effectiveness and patient safety. Below are important guidelines for its use:

• Route of Administration: Administered as an intravenous (IV) or intramuscular (IM) injection immediately after delivery of the baby’s anterior shoulder or within one minute after delivery to prevent postpartum hemorrhage.
• Dilution: The injection is usually given undiluted as a 1 ml dose containing 100 mcg of Carbetocin. For IV administration, it may be given as a slow injection or infusion over a few minutes.
• Timing: The timing is critical—administer the injection promptly after delivery as part of active management of the third stage of labor.
• Monitoring: Observe the patient for uterine tone and signs of bleeding following administration. Monitor vital signs closely, especially blood pressure and heart rate.
• Contraindications and Precautions: Avoid rapid IV bolus injection to reduce risk of hypotension. Use caution in patients with cardiovascular disease.
• Healthcare Provider Administration: Must be administered by trained healthcare professionals in a clinical setting with appropriate resuscitation facilities.

Following these administration guidelines maximizes the effectiveness of PABAL 100mcg in preventing postpartum hemorrhage while minimizing adverse effects.

Mode of Action PABAL 100mcg

Carbetocin, the active ingredient in PABAL 100mcg, acts by mimicking the natural hormone oxytocin. Its mechanism of action includes:

• Oxytocin Receptor Agonist: Carbetocin binds selectively to oxytocin receptors located on the uterine smooth muscle cells.
• Stimulates Uterine Contractions: Binding induces strong, rhythmic contractions of the uterine muscles, promoting effective uterine tone and reducing uterine atony (loss of muscle tone).
• Prolonged Activity: Compared to oxytocin, Carbetocin has a longer half-life, providing sustained uterotonic effect for up to an hour, which is beneficial in maintaining uterine tone after delivery.
• Prevention of Postpartum Hemorrhage: Effective uterine contractions help compress uterine blood vessels, minimizing bleeding from the placental site.
• Selective Effect: Primarily targets uterine tissue, with minimal systemic effects when used correctly.

By efficiently stimulating the uterus to contract, PABAL 100mcg plays a crucial role in reducing maternal morbidity and mortality associated with postpartum bleeding.

PABAL 100mcg Interactions PABAL 100mcg

Carbetocin can interact with certain drugs and conditions, which may influence its safety and efficacy. Important interactions include:

• Other Uterotonics: Concurrent use with other oxytocic or ergot alkaloids may potentiate uterine contractions, increasing risk of hyperstimulation or uterine rupture.
• Vasodilators and Antihypertensives: Co-administration with drugs that lower blood pressure may exacerbate hypotensive effects.
• General Anesthetics: Some inhalational anesthetics (e.g., halogenated agents) may reduce uterine contractility, potentially reducing the effectiveness of Carbetocin.
• Cardiovascular Drugs: Carbetocin can affect heart rate and blood pressure; caution is advised when used with beta-blockers or other cardiac medications.
• Conditions Affecting Cardiovascular System: Pre-existing hypertension, pre-eclampsia, or heart disease may alter response and increase adverse event risks.

Always inform your healthcare provider about all medications and pre-existing health conditions before administration.

Dosage of PABAL 100mcg

The recommended dosage of PABAL 100mcg for preventing postpartum hemorrhage is standardized but must be adapted to the clinical setting:

• Standard Dose: A single 100 mcg dose administered either as an intravenous injection or intramuscular injection immediately after delivery.
• Intravenous Administration: Administer slowly over 1 minute to reduce side effects such as hypotension or tachycardia.
• Intramuscular Administration: Can be given as a single injection if IV access is unavailable or impractical.
• Repeat Dosing: Generally not recommended due to prolonged half-life and sustained uterotonic effect.
• Special Populations: Dose adjustment may be necessary in patients with cardiovascular disease; use with caution.
• Clinical Guidelines: Follow institutional protocols and professional guidelines for postpartum hemorrhage prevention.

Adherence to recommended dosage ensures optimal uterine contraction and hemorrhage prevention while minimizing adverse effects.

Possible side effects of PABAL 100mcg

Although generally well tolerated, PABAL 100mcg can cause side effects. These include:

• Common Side Effects:
• Injection site reactions such as pain, redness, or swelling.
• Headache, nausea, vomiting.
• Uterine cramping or abdominal pain due to contractions.
• Cardiovascular Effects:
• Hypotension (low blood pressure), especially if given too rapidly IV.
• Tachycardia (increased heart rate).
• Flushing or warmth sensation.
• Rare but Serious Side Effects:
• Allergic reactions including rash, itching, or anaphylaxis.
• Uterine hyperstimulation, which can compromise fetal well-being in some settings.
• Chest pain or palpitations in sensitive individuals.

Patients should be monitored carefully during and after administration. Report any severe or unusual symptoms immediately to healthcare providers.

PABAL 100mcg Contraindications PABAL 100mcg

Use of PABAL 100mcg is contraindicated in certain conditions to prevent harm:

• Hypersensitivity: Known allergy to Carbetocin, Oxytocin, or any ingredients in the formulation.
• Active Cardiovascular Disease: Severe coronary artery disease, recent myocardial infarction, or significant hypertension.
• Uterine Abnormalities: Conditions that predispose to uterine rupture such as previous cesarean section with classical incision or uterine surgery.
• Fetal Distress: Situations where labor is contraindicated or active management of third stage is not appropriate.
• Use in Labor: Not indicated for induction or augmentation of labor, only for postpartum use.

Always review patient history and risk factors before administering PABAL 100mcg.

Storage of PABAL 100mcg

Proper storage of PABAL 100mcg ensures medication stability and safety:

• Temperature: Store refrigerated at 2°C to 8°C (36°F to 46°F). Do not freeze.
• Light Protection: Keep ampoules in their original packaging to protect from light.
• Handling: Inspect ampoules for damage or discoloration before use. Do not use if solution is cloudy or contains particulate matter.
• Shelf Life: Follow expiration date printed on the packaging.
• Storage Location: Store out of reach of children and unauthorized persons.

Maintaining recommended storage conditions ensures efficacy and prevents degradation of Carbetocin.