From the Research
Carbetocin and oxytocin have similar rates of nausea and vomiting when used for prevention of postpartum hemorrhage, with carbetocin possibly causing slightly less gastrointestinal side effects. Studies suggest that nausea occurs in approximately 10-15% of patients receiving carbetocin compared to 15-20% with oxytocin, while vomiting occurs in about 5-8% of carbetocin recipients versus 7-10% with oxytocin, as seen in a study published in 2022 1. The most recent and highest quality study, published in 2022, found that for cesarean section patients, there were no significant differences in nausea and vomiting between carbetocin and oxytocin 1. However, another study published in 2020 found that nausea, vomiting, and sweating were reported more significantly in the oxytocin group compared to the carbetocin group 2. Some key points to consider when choosing between these medications include:
- The standard dosing for carbetocin is a single 100 mcg IV or IM injection, while oxytocin typically requires continuous infusion (10-40 units in 1L fluid at 125-200 mL/hour) after an initial bolus.
- Carbetocin has a longer half-life (approximately 40 minutes) than oxytocin (3-5 minutes).
- Both medications are uterotonic agents that work by stimulating uterine contractions.
- The choice between these medications should consider other factors such as duration of action needed, cost, availability, and patient-specific factors rather than solely focusing on the minimal differences in nausea and vomiting rates. It's also important to note that carbetocin was associated with a reduced need for additional uterotonic agents and uterine massage compared to oxytocin, as seen in a study published in 2012 3. Overall, the decision to use carbetocin or oxytocin should be based on individual patient needs and clinical judgment, taking into account the potential benefits and risks of each medication.