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Carbate (Carbetocin)
Therapeutic Group: Gynaecological » Uterotonic Agent
Presentation
Carbate

Each ml injectable solution contains Carbetocin INN 100 mcg.

Descriptions
Carbetocin is a long-acting synthetic octapeptide analogue of oxytocin. It acts as an agonist at peripheral oxytocin receptors, particularly in the myometrium of uterus.
Indications
Carbetocin is indicated for the prevention of uterine atony and postpartum haemorrhage (excessive bleeding) following delivery of the infant by elective caesarean section under epidural or spinal anaesthesia.
Dosage & Administration
A single intravenous dose of 100 mcg (1 ml) of Carbate (carbetocin injection) is administered by bolus injection, slowly over 1 minute, only when infant delivery has been completed by caesarean section under epidural or spinal anaesthesia.
Carbate is to be used as a single dose only.
Side Effects
10-40% of patients experienced nausea, vomiting, abdominal pain, itching skin, increased body temperature, trembling and weakness. Infrequent adverse events (1-5% of patients) included back pain, dizziness, metallic taste, anaemia, sweating, chest pain, dyspnoea, chills, tachycardia and anxiety.
Precautions
In patients who may not have an adequate uterine contraction after a single injection of carbetocin, more aggressive treatment with additional doses of oxytocin or ergometrine is warranted.
As carbetocin is closely related in structure to oxytocin, hyponatraemia may occur.
Carbetocin should be used cautiously in the presence of epilepsy, migraine, asthma or any state in which a rapid addition to extracellular water may produce hazard for an already overburdened system.
Patients with eclampsia and pre-eclampsia should be monitored for changes in blood pressure.
Carbetocin is not recommended for use in elderly patients.
Contraindications
Carbetocin should not be used in patients with a history of hypersensitivity to oxytocin or carbetocin.
Carbetocin should not be used in patients with vascular disease, especially coronary artery disease, except with extreme caution.
Carbetocin is not intended for use in children.
Use in Pregnancy & Lactation
Use of carbetocin injection is contraindicated during pregnancy.

Use in lactation
Small amounts of carbetocin has been shown to cross over from plasma into the breast milk of nursing women. The small amount of carbetocin ingested by infant would not be expected to present a significant safety concern.
Drug Interaction
No specific drug interactions have been reported with carbetocin.
Overdose
Overdosage of carbetocin can be expected to produce enhanced pharmacological effects associated with uterine hyperactivity and pain. Treatment consists of symptomatic and supportive management.
Storage
Store at 2-8°C. Do not freeze. Keep away from light. Once the ampoule has been opened, the product should be used immediately.
Commercial Packaging
Carbate injection: Each box contains 1 ampoule.
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