Pabal (Carbetocin)

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

• Postpartum hemorrhage: Helps reduce the incidence of excessive bleeding following vaginal birth.
• Cesarean section recovery: Supports uterine tone after surgical delivery, lowering blood loss.
• Uterine atony: Improves uterine contractility when the uterus fails to contract adequately after delivery.

• Carbetocin binds to oxytocin receptors on uterine smooth muscle, activating the phosphoinositide signaling cascade that increases intracellular calcium. The rise in calcium triggers myometrial contraction, producing a sustained uterotonic effect that helps control postpartum bleeding.

Adverse reactions to carbetocin are generally mild to moderate and reflect its uterotonic activity.

Common Side Effects

• Nausea: Mild to moderate feeling of sickness.
• Headache: Transient headache during the immediate post‑administration period.
• Flushing: Warmth or redness of the skin, often on the face or neck.
• Transient hypertension: Short‑term rise in blood pressure.
• Vaginal bleeding: Slight spotting that resolves spontaneously.

Serious or Rare Side Effects

• Severe hypertension: Marked increase in blood pressure requiring medical intervention.
• Cardiac arrhythmia: Abnormal heart rhythm that may need monitoring.
• Anaphylaxis: Rare severe allergic reaction with hives, swelling, and respiratory difficulty.
• Uterine rupture: Extremely rare tearing of the uterine wall.
• Pulmonary edema: Fluid accumulation in the lungs, presenting with shortness of breath.

Carbetocin should be administered by qualified healthcare professionals who can monitor maternal vital signs and uterine response.

• Contraindication: Known hypersensitivity to carbetocin or oxytocin analogs.
• Cardiovascular monitoring: Observe blood pressure and heart rate during and after administration.
• Fluid balance: Assess patient’s fluid status to avoid overload.
• Pre‑existing hypertension: Use cautiously in patients with uncontrolled high blood pressure.
• Store at ambient temperature: Keep in original packaging, protect from moisture and direct sunlight.

Carbetocin may interact with other agents that affect cardiovascular function or uterine tone.

Major Interactions (Avoid)

• Vasopressors: May exacerbate hypertension when combined with carbetocin.
• β‑blockers: Can blunt heart‑rate response, complicating hemodynamic monitoring.

Moderate Interactions (Monitor Closely)

• Antihypertensive drugs: May require dose adjustment of either agent.
• Magnesium sulfate: Can potentiate uterine relaxation, reducing carbetocin efficacy.
• Anesthetic agents: May alter uterine contractility and hemodynamic response.