Indications

Carbetocin is used to avoid uterine atony and postpartum haemorrhage (excessive bleeding) after an infant is delivered via elective caesarean section with epidural or spinal anaesthetic.

Pharmacology

A single intravenous dose of 100 mcg of 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. carbetocin is to be used as a single dose only.

Dosage & Administration

Ciclopirox Cream should be gently massaged onto the affected and surrounding skin areas twice daily for four weeks. Clinical improvement with relief of pruritus and other symptoms usually occurs within the first week of treatment. If a patient shows no clinical improvement after four weeks of treatment with Ciclopirox cream, the diagnosis should be redetermined. Patients with Tinea versicolor usually exhibit clinical and mycological clearing after two weeks of treatment.

Use in children: Safety and effectiveness in children below the age of 10 years have not been established.

Interaction

No specific drug interactions have been reported with carbetocin.

Contraindications

Because of its long duration of action relative to oxytocin, uterine contractions produced by carbetocin cannot be stopped by simply discontinuing the medication. Therefore, carbetocin should not be administered prior to delivery of the infant for any reason, including elective or medical induction of labour. Inappropriate use of carbetocin during pregnancy could theoretically mimic the symptoms of oxytocin overdosage, including hyperstimulation of the uterus with strong (hypertonic) or prolonged (tetanic) contractions, tumultuous labour, uterine rupture, cervical and vaginal lacerations, postpartum haemorrhage, utero-placental hypoperfusion and variable deceleration of foetal heart, foetal hypoxia, hypercapnia, or death. Carbetocin should not be used in patients with a history of hypersensitivity to oxytocin or carbetocin. Carbetocin should not be used in patients with cardio vascular disease, especially coronary artery disease, valvular heart disease, cardiomyopathy and heart failure. Carbetocin is not intended for use in children.

Side Effects

Nausea, vomiting, abdominal pain, itchy skin, elevated body temperature, shaking, and weakness were reported by 10-40% of patients. Back discomfort, dizziness, metallic taste, anemia, sweating, chest pain, dyspnoea, cold, tachycardia, and anxiety were all reported infrequently (1-5 percent of patients).

Pregnancy & Lactation

Using carbetocin injections during pregnancy is not advised. Carbetocin has been found to pass from plasma into the breast milk of nursing mothers in small levels. The modest amount of carbetocin consumed by the infant is unlikely to pose a significant safety risk.

Precautions & Warnings

More aggressive treatment with multiple doses of oxytocin or ergometrine is necessary in patients who do not have an adequate uterine contraction following a single injection of carbetocin.

Hyponatraemia can arise because carbetocin is structurally similar to oxytocin.

Carbetocin should be used with caution if you have epilepsy, migraines, asthma, or any other condition where a sudden increase in extracellular water could endanger an already overworked system.

Changes in blood pressure should be observed in patients with eclampsia and pre-eclampsia.

Carbetocin should not be used in elderly people.

Therapeutic Class

Drugs acting on the Uterus

Storage Conditions

Temperatures should be kept between 2 and 8 degrees Celsius. Do not allow yourself to become frozen. Keep your distance from the light. The product should be used right away after the ampoule has been opened.

Pharmaceutical Name

Incepta Pharmaceuticals Ltd.