Carbetocin

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Generic Name of Carbetocin - Learn More

Carbetocin

Carbetocin Precaution - What You Need to Know

Before initiating treatment with Carbetocin, it is crucial that patients consult with their healthcare provider, as this medication is primarily used for preventing postpartum hemorrhage (excessive bleeding after childbirth) and has several important precautions:
- Cardiovascular Conditions: Carbetocin should be used with caution in patients with cardiovascular disease, including those with hypertension, ischemic heart disease, or a history of stroke, as it can cause changes in blood pressure and may increase the risk of adverse cardiovascular events.
- Uterine Rupture: It should be used with caution in women with a history of uterine surgery (such as cesarean section or myomectomy), as it may increase the risk of uterine rupture when used for uterine contractions.
- Fluid Retention: Carbetocin, like other oxytocin analogs, can cause fluid retention. Patients with conditions that may predispose them to edema (such as heart or kidney disease) should be carefully monitored during treatment.
- Renal or Hepatic Impairment: In patients with renal or hepatic impairment, Carbetocin should be used with caution, as impaired liver or kidney function may affect the drug's metabolism and elimination.
- Pregnancy and Lactation: Carbetocin is specifically used for managing postpartum hemorrhage and is safe when administered post-delivery. It should not be used during pregnancy except for its intended purpose (prevention of postpartum hemorrhage). There is no conclusive evidence on whether Carbetocin is excreted in breast milk, so it should only be used during breastfeeding if the benefit outweighs the potential risk to the infant.
- Allergic Reactions: Patients should inform their healthcare provider if they have a history of allergic reactions to any oxytocin-related drugs, as Carbetocin may cause allergic reactions, including rash, pruritus, or anaphylaxis.

Carbetocin Indication - Uses and Benefits

Carbetocin is a synthetic analog of oxytocin and is primarily indicated for:
- Prevention of Postpartum Hemorrhage (PPH): It is primarily used to prevent excessive bleeding after childbirth, particularly in women at high risk for PPH. Carbetocin promotes uterine contraction, which helps reduce bleeding and supports the process of placental expulsion.
- Cesarean Section: It is commonly used in cesarean sections to reduce the risk of hemorrhage by promoting uterine tone and contraction post-delivery.
- Intrauterine Procedures: Carbetocin may also be considered for other intrauterine procedures where uterine tone is necessary to control bleeding.

Carbetocin Contraindications - Important Warnings

Carbetocin should not be used in certain situations:
- Hypersensitivity: Contraindicated in patients who are allergic to carbetocin or any of its components, or those with a known sensitivity to oxytocin or other oxytocin analogs.
- Active Vaginal Bleeding: It is contraindicated in the presence of active vaginal bleeding from non-obstetric causes (such as uterine malignancy or other serious conditions), as the uterine contractions induced by carbetocin may worsen bleeding in these situations.
- Severe Renal Impairment: Contraindicated in patients with severe renal impairment (e.g., creatinine clearance <30 mL/min), as the drug may accumulate in the body, increasing the risk of adverse effects.
- Pregnancy and Labor: Although used postpartum, carbetocin is contraindicated during labor and before delivery unless it is specifically required for medical management of bleeding post-delivery.
- Uterine Rupture Risk: Avoid use in women with a history of uterine rupture or abnormal uterine anatomy, as the risk of uterine rupture or damage may increase.

Carbetocin Side Effects - What to Expect

The most common and severe side effects associated with Carbetocin use include:
- Hypotension: A drop in blood pressure is common and may occur due to the vasodilation caused by the medication. Severe hypotension can be particularly concerning in patients with pre-existing cardiovascular conditions.
- Bradycardia: Carbetocin may lead to slowed heart rate (bradycardia), which may necessitate medical intervention if it becomes pronounced.
- Uterine Hyperstimulation: Excessive contractions of the uterus (uterine hyperstimulation) can occur, leading to fetal distress, uterine rupture, or placental abruption. This can be dangerous for both the mother and baby.
- Headache: Some patients may experience headaches, which are generally mild but can be distressing.
- Nausea and Vomiting: Carbetocin can cause nausea, vomiting, or an upset stomach, which may resolve with time.
- Fluid Retention: Due to its oxytocin-like activity, Carbetocin can cause fluid retention or edema, especially when used over extended periods.
- Allergic Reactions: Some individuals may experience allergic reactions including rash, itching, or even more severe reactions such as anaphylaxis.
- Postpartum Hemorrhage: While rare, carbetocin itself may contribute to complications in postpartum hemorrhage in patients who do not respond to the treatment, requiring additional medical management.

Carbetocin Mode of Action - How It Works

Carbetocin works by mimicking the natural hormone oxytocin, which is involved in several physiological processes, including uterine contractions and milk ejection:
- Uterine Contractions: Carbetocin binds to oxytocin receptors in the smooth muscle of the uterus, stimulating contraction of the uterine muscles. These contractions help to reduce bleeding by promoting the closure of blood vessels in the uterine wall and aiding in the expulsion of the placenta after childbirth.
- Prevention of Postpartum Hemorrhage: By enhancing uterine tone and reducing bleeding, carbetocin helps prevent postpartum hemorrhage, particularly in women who may have an increased risk of excessive bleeding.
- Longer Duration of Action: Compared to oxytocin, carbetocin has a longer duration of action, making it more suitable for the prevention of hemorrhage after delivery.

Carbetocin Drug Interactions - What to Avoid

Carbetocin may interact with other medications and substances:
- Other Oxytocic Agents: When combined with other oxytocic drugs (e.g., oxytocin or prostaglandins), there may be an increased risk of uterine hyperstimulation (excessive contractions), which can lead to uterine rupture, fetal distress, or placental abruption.
- Vasoconstrictors: Concomitant use of vasoconstrictors (e.g., epinephrine, dopamine) may lead to an increased risk of severe hypertension, as both carbetocin and vasoconstrictors can increase blood pressure.
- Antihypertensive Medications: As carbetocin can lead to a rise in blood pressure, caution should be exercised when used with antihypertensive medications, especially in individuals with pre-existing hypertension.
- Anesthetic Agents: Carbetocin should be used cautiously in patients receiving general anesthesia, as it can enhance the effects of hypotensive agents or other drugs used during the procedure.
- Corticosteroids: There is some evidence that corticosteroids may interact with carbetocin, potentially affecting its ability to stimulate uterine contractions, although such interactions are typically minimal.

Carbetocin Adult Dose - Recommended Dosage

The typical adult dose of Carbetocin for the prevention of postpartum hemorrhage is:
- Single Dose: A single dose of 100 micrograms is administered via intravenous (IV) injection or intramuscular (IM) injection immediately after the delivery of the baby. The injection is usually given after the placenta is delivered, and it helps reduce the risk of excessive bleeding by promoting uterine contraction.
- Postpartum Use: It is typically administered as part of a comprehensive postpartum care plan to reduce the risk of hemorrhage, especially in high-risk cases like cesarean sections.

Carbetocin Child Dose - Dosage for Children

The safety and efficacy of Carbetocin in pediatric patients have not been established, and it is not indicated for use in children. The medication is intended for adult use only, particularly for managing postpartum hemorrhage. Therefore, its use in children is not recommended unless under exceptional circumstances and under the strict supervision of a pediatric specialist.

Carbetocin Renal Dose - Dosage for Kidney Conditions

Carbetocin should be used with caution in patients with renal impairment. For individuals with moderate to severe renal impairment (e.g., creatinine clearance <30 mL/min), the drug’s metabolism and excretion may be delayed, which could increase the risk of side effects or systemic absorption. Dose adjustments are typically not provided, but healthcare providers should closely monitor these patients for any adverse reactions.