Carbetocin: A Comprehensive Pharmacological and Clinical Monograph

Introduction

Carbetocin is a long-acting, synthetic nonapeptide analogue of the endogenous human hormone oxytocin, engineered to possess enhanced stability and a prolonged duration of action.[1] It has established a prominent position in modern obstetric practice as a critical uterotonic agent, a class of drugs that stimulates contraction of the myometrium.[1] The principal clinical indication for Carbetocin is the prevention of postpartum hemorrhage (PPH), a life-threatening complication of childbirth characterized by excessive bleeding.[5] Its use is particularly well-established following Cesarean section and is increasingly supported for the prevention of PPH after vaginal delivery.[8]

The primary pharmacological distinction and clinical advantage of Carbetocin over oxytocin, the conventional first-line uterotonic, lies in its significantly longer biological half-life and duration of action.[10] This superior pharmacokinetic profile, a direct result of specific structural modifications to the oxytocin peptide, allows for effective uterine tone to be achieved and maintained with a single bolus injection. This contrasts sharply with the short half-life of oxytocin, which often necessitates a prolonged intravenous infusion to prevent uterine atony, the most common cause of PPH.[10]