Pabal (Carbetocin)

Carbetocin is used in obstetric care to promote uterine contraction and reduce bleeding after delivery.

• Postpartum hemorrhage: Improves uterine tone and reduces blood loss following vaginal birth.
• Cesarean section recovery: Supports uterine contraction to minimise intra‑operative and post‑operative bleeding.
• Uterine atony: Restores adequate uterine tone when the uterus fails to contract adequately after delivery.

• Carbetocin is a synthetic analogue of oxytocin that binds selectively to oxytocin receptors in the uterine smooth muscle. Activation of these G‑protein‑coupled receptors triggers intracellular calcium release, leading to sustained uterine contraction and reduced postpartum bleeding.

Carbetocin may cause a range of adverse reactions, most of which are mild to moderate in severity.

Common Side Effects

• Nausea: Mild to moderate nausea reported in some patients.
• Headache: Transient headache occurring shortly after administration.
• Flushing: Warmth or redness of the skin, typically on the face or neck.
• Hypotension: Mild drop in blood pressure, usually self‑limiting.
• Tachycardia: Temporary increase in heart rate.

Serious or Rare Side Effects

• Anaphylaxis: Severe allergic reaction requiring immediate medical attention.
• Myocardial ischemia: Rare cardiac event presenting as chest pain or ECG changes.
• Pulmonary edema: Uncommon fluid accumulation in the lungs.
• Seizures: Very rare neurologic event.
• Severe hypotension: Marked blood pressure drop needing intervention.

When using Carbetocin, clinicians should consider several safety measures to minimise risk.

• Contraindication: Do not use in patients with known hypersensitivity to carbetocin or oxytocin analogues.
• Cardiovascular monitoring: Observe blood pressure and heart rate during and after administration.
• Fluid balance: Assess patient fluid status to avoid overload in at‑risk individuals.
• Pregnancy status: Use only after delivery; it is not indicated for use during pregnancy.
• Storage: Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Carbetocin may interact with other medications that affect cardiovascular function or uterine activity.

Major Interactions (Avoid)

• Vasodilators: May potentiate hypotensive effects, increasing risk of severe low blood pressure.
• Beta‑blockers: Can blunt compensatory heart‑rate response to hypotension.

Moderate Interactions (Monitor Closely):\n- Antihistamines: May mask early signs of an allergic reaction.

• Magnesium sulfate: Can enhance uterine relaxation, reducing carbetocin efficacy.
• General anaesthesia agents:
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