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Carbetocin parenteral

Updated 2 Feb 2023 | Oxytocics


Injection of carbetocin.

Drugs List

  • carbetocin 100microgram/1ml injection
  • PABAL 100microgram/1ml injection
  • Therapeutic Indications


    Postpartum haemorrhage following vaginal delivery: Prevention
    Prevention of uterine atony after Caesarean section



    100micrograms as a single dose as soon as possible after delivery and preferably before removal of the placenta.


    Vaginal Delivery
    Intramuscular injection or by slow intravenous injection over 1 minute.

    Caesarean Section under spinal anaesthesia or epidural
    Slow intravenous injection over 1 minute.


    Epileptic disorder
    Hepatic impairment
    Long QT syndrome
    Renal impairment
    Severe cardiovascular disorder
    Torsade de pointes

    Precautions and Warnings

    Family history of long QT syndrome
    Cardiovascular disorder
    Electrolyte imbalance
    History of torsade de pointes

    Correct electrolyte disorders before treatment
    Not all routes are licensed for all indications
    Treatment to be initiated and supervised by a specialist
    For intravenous or intramuscular administration only
    Consider monitoring ECG in patients at risk of QT prolongation
    If uterine atony persists after single dose, consider alternative treatment
    If uterine bleeding persists after administration, investigate cause
    May cause hyponatraemia
    Monitor serum electrolytes
    Consider hyponatraemia in all patients with drowsiness/confusion/seizures

    If uterine bleeding persists after administration, the cause must be determined. Retained placental fragments, inadequate emptying or repair of the uterus, perineal, vaginal or cervix lacerations or impaired blood coagulation may be causative factors.

    Carbetocin is for use on a single occasion. If uterine hypotonia or atony persists additional therapy should be considered with another uterotonic.

    Animal studies have demonstrated that carbetocin has some antidiuretic activity, which may lead to hyponatraemia. This effect is more likely in patients receiving large volumes of intravenous fluids. Early signs of drowsiness, listlessness and headache should be recognised in order to prevent convulsions and coma.

    Use with caution in patients with migraine, asthma, cardiovascular disorders or any other condition in which a rapid addition to extracellular water may put the patient at risk. These patients should only be treated after careful consideration of the benefits and risks of treatment.

    Carbetocin administration to patients with gestational diabetes has not been studied.

    Pregnancy and Lactation


    Carbetocin is contraindicated during pregnancy.

    Use of carbetocin during pregnancy is contraindicated by the manufacturer. At the time of writing there is limited published information regarding the use of carbetocin during pregnancy. Potential risks are unknown.


    Carbetocin is considered safe for use during breastfeeding.

    The manufacturer states that carbetocin may be used safely when breastfeeding. Carbetocin has been shown to pass from plasma into breast milk in small amounts, and is assumed to be broken down in the gut of the neonate. No significant effects on milk let down have been reported during clinical trials.

    Side Effects

    Abdominal pain
    Back pain
    Chest pain
    Metallic taste
    Myocardial ischaemia
    Pain - generalised
    Prolongation of QT interval
    Sensation of warmth


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: July 2022

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Summary of Product Characteristics: Pabal 100 micrograms in 1ml solution for injection. Ferring Pharmaceuticals Ltd. Revised December 2019.

    NICE Evidence Services Available at: Last accessed: 27 July 2022

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