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carbetocin (Lonactene / Duratocin / Pabal)

✓ Approved

Ferring · OXTR · Small Molecule

What is carbetocin?

carbetocin is a small molecule developed by Ferring. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesLonactene, Duratocin, Pabal
CompanyFerring
Drug ClassSmall Molecule
Molecular TargetOXTR
RouteInjectable (Others), Intravenous (IV)
StatusApproved
Sources: ClinicalTrials.gov, Ferring

Mechanism of Action

Molecular Targets

carbetocin acts on 1 molecular target:

OXTRoxytocin receptor (OTR, OT-R)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

carbetocin is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Pregnancy, puerperium and perinatal conditionsPostpartum haemorrhage✓ Approved

Related Research Articles

PubMedClinical therapeutics2026-07-23

Carbetocin Nasal Spray for the Treatment of Hyperphagia in Prader-Willi Syndrome: Results From the Randomized, Placebo-Controlled, Phase 3 Compass PWS Study.

Roof Elizabeth E, Strong Theresa V TV, Stafford Diane E J DEJ, Singh Deepan D et al.

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by endocrine and neuropsychiatric problems including hyperphagia, anxiousness, and distress. The oxytocinergic system represents one of the key neural circuits that is dysfunctional in PWS, making it an attractive therapeutic target. The oxytocin analog carbetocin has a longer half-life and greater receptor selectivity than oxytocin and showed therapeutic potential in the phase 3 CARE-PWS study (ClinicalTrials.gov NCT03649477) based on nominally significant improvements in hyperphagia and anxiousness with the 3 times daily (TID) 3.2-mg dose of intranasal carbetocin over placebo. The phase 3 placebo-controlled COMPASS PWS study was conducted to confirm the potential benefit observed with carbetocin in the CARE-PWS study. In the 12-week COMPASS PWS study (ClinicalTrials.gov NCT06173531), 175 participants were randomized 1:1 to carbetocin 3.2 mg TID nasal spray (n = 85) and placebo (n = 90). The primary efficacy endpoint was the change from baseline at week 12 in the Hyperphagia Questionnaire for Clinical Trials (HQ-CT) score. Secondary efficacy endpoints were the change in the Clinical Global Impression-Severity (CGI-S) score for PWS, and in the CGI-S for hyperphagia in PWS score from baseline at week 12, the CGI-Change for PWS score at week 12, and the percentage of participants with a treatment response (defined as improvement from baseline ≥8 points) based on the HQ-CT at week 12. Exploratory efficacy endpoints included the change from baseline at week 12 in scores for the PWS Anxiousness and Distress Behaviors Questionnaire. The least squares mean change (standard error) from baseline at week 12 in the HQ-CT was -4.8 (0.8) and -5.1 (0.8) in the carbetocin and placebo groups, respectively; the treatment difference of 0.3 (95% confidence interval: -1.8, 2.4; P = 0.79) was not statistically significant. There was no separation between carbetocin and placebo for any secondary or exploratory endpoint. The most frequently reported treatment-emergent adverse events in the carbetocin-treated participants were headache (n = 6 [7.2%]) and pyrexia (n = 5 [6.0%]). Carbetocin nasal spray did not demonstrate efficacy compared with placebo for hyperphagia in PWS in the 12-week COMPASS PWS study.

PMID 42486751
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PubMedMaternal-fetal medicine (Wolters Kluwer Health, Inc.)2026-07-22

Carbetocin in the Prevention of Postpartum Hemorrhage after Vaginal Birth: A Systematic Review and Meta-Analysis.

El-Goly Nour A NA, Maged Ahmed M AM, Shamel Ahmed A, El-Sherbiny Wael W

To evaluate the safety and efficacy of carbetocin for reducing blood loss following vaginal delivery (VD). Databases, including MEDLINE, Scopus, Web of Science, EMBASE, Cochrane Library, Scopus, and clinical trial registries, were screened from inception to November 2024 using keywords related to carbetocin, postpartum hemorrhage (PPH), postpartum blood loss, and VD. Only randomized controlled trials included participants who underwent VD, totaling 19 studies including 69,884 women. Seventeen studies were published in English, one in Spanish, and one in Chinese. The extracted data included study location, number of participants and characteristics, intervention (including dose, route, and timing of administration), primary and secondary outcome parameters, and trial registration details. Thirteen studies with 64,731 participants compared carbetocin to oxytocin. Blood loss in the first 24 h was assessed in ten trials (7403 participants), which reported a mean difference (MD) of -28.13 mL (95% confidence interval (CI): -51.76, -4.50; P = 0.020). The difference between antepartum and postpartum hemoglobin levels was measured in seven trials (2737 participants), which reported an MD of -0.39 g/dl (95% CI: -0.48, -0.29; P < 0.001). PPH > 500 mL and severe PPH > 1000 mL were reported in ten and seven studies (64,416 and 63,789 participants, respectively), with odds ratios (ORs) of 0.99 (95% CI: 0.89, 1.10; P = 0.800) and 0.98 (95% CI: 0.89, 1.09; P = 0.720), respectively. The need for additional uterotonics was assessed in ten trials (34,852 participants), with an OR of 0.67 (95% CI: 0.49, 0.90; P = 0.008). Six studies (10,145 participants) compared carbetocin to syntometrine. Blood loss in the first 24 h was assessed in five trials (4853 participants), which reported an MD of -35.29 mL (95% CI: -75.68, 5.09; P = 0.090). The difference between the antepartum and postpartum hemoglobin levels was measured in four trials (860 participants), which reported an MD of -0.29 g/dl (95% CI: -0.48, -0.09; P = 0.004). PPH > 500 mL and severe PPH > 1000 mL were reported in five and four studies (4835 and 4733 participants, respectively), with ORs of 1.09 (95% CI: 0.96, 1.24; P = 0.170) and 0.93 (95% CI: 0.78, 1.09; P = 0.360), respectively. The need for additional uterotonics was calculated in five trials (4933 participants), with an OR of 0.93 (95% CI: 0.60, 1.46; P = 0.770). Carbetocin administration was associated with reduced blood loss during the first 24 h after VD, a less severe decrease in postpartum hemoglobin levels, and a reduced need for additional uterotonics compared with oxytocin administration. Registration number CRD42023492407.

PMID 42483292
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PubMedBMC pregnancy and childbirth2026-07-21

Prevention and management of postpartum hemorrhage and hypertensive disorders of pregnancy: results from a 31-country rapid assessment.

Sharma Gaurav G, Noriega Angeline A, Somji Aleefia A, Blockett Andre A et al.

Postpartum hemorrhage (PPH) and Hypertensive Disorders of Pregnancy (HDP) remain leading causes of maternal death. This multi-country survey asked key informants to assess uptake of evidence-based practices; determine their country's implementation of updated WHO global guidelines; and describe the private sector's role in PPH and HDP management. To our knowledge, this is among the few multi-country assessments to examine national implementation of updated WHO recommendations for PPH and HDP alongside private-sector engagement across three major regions-sub-Saharan Africa, South and Southeast Asia, and Latin America and the Caribbean-providing a comparative view to guide advocacy and programme planning. From January to May 2022, 35 countries in sub-Saharan Africa, South and Southeast Asia, and Latin America and the Caribbean were invited to complete a survey (based on 2011 and 2012 surveys) on PPH and HDP management across public and private sectors on PPH and HDP management. Using purposive sampling, country-based focal persons assembled national expert teams from public and private sectors in health policy, education, procurement/distribution, logistics, and information systems to complete the survey. Teams produced consensus-based answers by reviewing nationally available data and policy documents. The Study Team developed composite scores for key quantitative indicators and thematically analyzed qualitative data. Thirty-one countries completed the survey. Despite significant progress since 2012, several gaps remain. Oxytocin was reported as regularly available in public facilities by 77% of countries and in private facilities by 84% of countries. Magnesium sulfate was reported as available in public facilities by 58% of countries and in private facilities by 45% of countries. Interventions like umbilical vein injection of oxytocin for retained placenta (13% of countries) and heat-stable carbetocin for PPH prevention (45% of countries) were less integrated in national policy guidelines. Since 2011, midwifery scope of practice remained stagnant for manual removal of placenta for PPH, diagnosing severe pre-eclampsia/eclampsia, and giving the loading dose of MgSO4, but 60% of countries in 2022 reported that newer PPH treatments (such as tranexamic acid) were included. Quality assurance systems for procurement of essential drugs and data reporting into national information systems were deficient, particularly in the private sector. Recommendations include prioritizing integration of updated global guidelines; improving uptake through professional education, mentorship, and supervision; quality assurance; strengthening procurement and supply chains to improve access, availability, and quality of essential drugs and commodities; expanding midwives' scope of practice; and improving private sector governance to enhance reporting of important MNH indicators.

PMID 42477613
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PubMedJournal of the American Society for Mass Spectrometry2026-07-17

Strategies for the Identification of Cyclic Peptide Drugs and Their Impurities.

Long Zhen Z, Zhang Wei W, Zhu Xiang X, Luo Xi X

Cyclic peptide drugs pose significant analytical challenges due to their constrained architectures and multiple intramolecular linkages, which complicate fragmentation behavior and hinder structural identification. In this study, electron-transfer/higher-energy collision dissociation (EThcD) was systematically optimized to analyze three clinically relevant classes of cyclic peptides: disulfide-bridged, ester- and disulfide-bridged, and macrolactam-bridged peptides. Compared with higher-energy collisional dissociation (HCD) and electron transfer dissociation without supplemental activation (ETnoD), EThcD significantly increased the abundance of both c/z and b/y fragment ions, providing an improved sequence coverage. Distinct diagnostic fragmentation behaviors were observed. Disulfide-bridged cyclic peptides exhibited dominant M33 neutral losses associated with HS• elimination. Ester- and disulfide-bridged peptides generated both M-33 and M-46 fragments, corresponding to HS• and CH2S losses. Macrolactam-bridged peptides showed characteristic M-28 neutral losses consistent with CO elimination. These neutral losses serve as diagnostic markers for rapid classification and impurity identification. Targeted MS3 experiments further supported the proposed formation mechanisms of these product ions. An EThcD MS2-CID MS3 strategy was also evaluated to investigate fragmentation mechanisms. However, for sequence determination, EThcD MS2 spectra provided more regular c/z ion series and reduced spectral complexity, enabling straightforward analysis using commercial software. Applying optimized EThcD conditions and established fragmentation rules, impurities in atosiban and carbetocin were characterized, leading to the identification of three impurities in atosiban and two in carbetocin. This approach demonstrates the effectiveness of EThcD for structural elucidation and impurity profiling of cyclic peptide therapeutics.

PMID 42463469
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PubMedBMC pregnancy and childbirth2026-07-12

Carbetocin and oxytocin use in emergency cesarean delivery: a prospective observational study of 24-hour bleeding outcomes.

Eryılmaz Tahir T, Gayretli Tuğba Kolomuç TK, Şefik Selver Özge SÖ, Küçükkayıcı Ayşe Sena AS et al.

Postpartum hemorrhage remains a major cause of maternal morbidity, and cesarean delivery is associated with greater blood loss than vaginal birth. This study evaluated 24-hour bleeding-related outcomes among antenatally low-risk women who received prophylactic oxytocin or carbetocin after National Institute for Health and Care Excellence (NICE) Category 1-2 emergency cesarean delivery and identified intrapartum factors associated with additional uterotonic use. This prospective observational, non-randomized comparative study was conducted between October 2024 and August 2025. Antenatally low-risk women admitted for intended vaginal birth who subsequently required NICE Category 1-2 emergency cesarean delivery received oxytocin 10 IU intravenous (IV) or carbetocin 100 µg IV immediately after delivery. The primary outcome was any additional uterotonic use within 24 h. Secondary outcomes were tranexamic acid use, hemoglobin decrease ≥ 2 g/dL at 24 h, absolute hemoglobin change (ΔHb), and postoperative hemoglobin < 8 g/dL. Multivariable logistic regression was performed for the primary outcome. A total of 300 women were included, with 150 in each group. Additional uterotonic use occurred in 24.0% (36/150) of the carbetocin group and 33.3% (50/150) of the oxytocin group (p = 0.074). Tranexamic acid use did not differ significantly between groups (18.7% vs. 16.0%, p = 0.542). Hemoglobin decrease ≥ 2 g/dL occurred in 68.0% and 60.0%, respectively (p = 0.149). Mean ΔHb was 2.49 ± 1.13 g/dL in the carbetocin group and 2.38 ± 1.03 g/dL in the oxytocin group (p = 0.388). Postoperative hemoglobin < 8 g/dL occurred in 11.3% and 12.0%, respectively (p = 0.981). In multivariable analysis, induction/augmentation (adjusted OR 1.92, 95% CI 1.07-3.42, p = 0.028) and longer duration of membrane rupture (adjusted OR 1.23 per doubling, 95% CI 1.06-1.43, p = 0.006) were independently associated with additional uterotonic use, whereas uterotonic group was not (adjusted OR for oxytocin vs. carbetocin 1.51, 95% CI 0.90-2.54, p = 0.122). In this prospective observational non-randomized cohort of antenatally low-risk women undergoing emergency cesarean delivery, no statistically significant between-group differences were observed in additional uterotonic use or predefined 24-hour bleeding-related outcomes. Additional uterotonic use was numerically lower with carbetocin, but the difference was not statistically significant. Induction/augmentation and longer duration of membrane rupture were independently associated with higher odds of additional uterotonic use. ClinicalTrials.gov (NCT07380529), first submitted on 18 January 2026. Retrospectively registered.

PMID 42436390
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PubMedGenes, brain, and behavior2026-07-10

Untangling Mephedrone-Induced Social Reward in Rats-The Involvement of Oxytocin and Vasopressin V1A Receptors.

Wronikowska-Denysiuk Olga O, Kurach Łukasz Ł, Mlak Radosław R, Przygodzka Dominika D et al.

The rewarding effects of psychostimulants are strongly influenced by social context, yet the underlying neurochemical and neuropeptidergic mechanisms remain unclear. This study examined the role of oxytocin (OT) and vasopressin (AVP) in context-dependent reward induced by subchronic mephedrone treatment in rats. Using classic- and social-conditioned place preference (CPP) we assessed reward and later-monoamine levels in the prefrontal cortex (PFC) and hippocampus, plasma OT and AVP levels, and mRNA expression of oxytocin (OTRs) and vasopressin V1A (AVPV1ARs) receptors in the nucleus accumbens (NAc) and hippocampus. Pharmacological manipulations of OTRs and AVPV1ARs were used to evaluate their role in social-CPP. We confirmed that mephedrone (5 mg/kg) induced social- but not classic-CPP. In classic-CPP, mephedrone elevated PFC dopamine, an effect abolished under social conditioning, which instead reduced hippocampal serotonin and noradrenaline. Social context alone lowered baseline monoamines, suggesting dampened neurochemical signaling. Social conditioning increased plasma OT and AVP, whereas mephedrone selectively reversed the OT rise. At the receptor level, mephedrone up-regulated AVPV1AR mRNA in the hippocampus and OTR mRNA in the NAc, indicating central adaptations distinct from peripheral peptide changes. Behaviorally, social-CPP was abolished by OTR agonism (carbetocin) or AVPV1AR antagonism (SR49059), while OTR antagonism (L-368,899) or peripheral AVP had no effect. These findings show that mephedrone-induced social reward is shaped by OT and AVP systems. Social context modulates peripheral neuropeptides and engages central receptor adaptations in the hippocampus and NAc, influencing behavioral outcomes. This study provides insights into the neurobiological mechanisms through which the social environment alters drug reward.

PMID 42429340
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