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Reproductive & sexual health

Carbetocin

A long-acting oxytocin analogue approved in many countries — but not the US — to prevent uterine atony after delivery.

L4Strong humanApproved — specific region(s)ApprovedModerate confidenceLast reviewed 2026-08-23
IVIM

Also known as: Duratocin, Pabal

Evidence passport

Last reviewed 2026-08-23

Evidence level
L4Strong human
Confidence
Moderate confidence
Human efficacy
70/100
Human safety
70/100
Regulatory status
Approved — specific region(s)
Development
Approved
Routes
IVIM
Evidence base
Includes human data
Furthest stage
Approved
Source curation
Sources fully curated
Clinical maturity
Approved regionally; long clinical use

Overview

Human evidence70/100
Preclinical evidence70/100
Human safety evidence70/100

Clinical maturity: Approved regionally; long clinical use

Routes & formulations

Studied / approved routes

IVIM

Given as a single injection (IV or IM depending on the national label) in the peripartum setting.

Route availability is not evidence of efficacy, and evidence from one route does not transfer to another. The Registry never provides dosing or sourcing information.

Peptide lifecycle

  1. Discovery

  2. Preclinical

  3. Phase I

  4. Phase II

  5. Phase III

  6. Approved

Approved

Approved through national procedures in many markets; no US development programme is established in the curated record.

What it is

A modified oxytocin analogue engineered for longer action, used where a sustained uterotonic effect is wanted after delivery.

What people claim

  • Prevents uterine atony and excessive bleeding after caesarean delivery

What the evidence actually says

Randomised trials support its uterotonic role in the settings covered by national labels. It is a useful illustration that approval is regional: widely used in Europe and elsewhere, absent from the US market.

Human evidence

  • Randomised controlled trials versus oxytocin in caesarean and postpartum settings.
  • National regulatory assessments across multiple markets.

Preclinical evidence

  • Oxytocin-analogue receptor pharmacology with extended duration of action.

Animal and cell findings are Level 1–2 evidence.

Mechanism and pathways

  • Oxytocin-receptor agonism with slower degradation produces a prolonged uterotonic effect.

Safety and unknowns

  • Adverse-effect profile is broadly similar to oxytocin within labelled use.
  • Not interchangeable with unregulated oxytocin-like research products.

Cancer relevance

No concern identified

No established human cancer signal within approved use.

Regulatory status

Authorised in numerous countries through national approvals, including across EU member states via national procedures, for prevention of uterine atony and postpartum haemorrhage in specified obstetric settings. Not FDA-approved; EMA material describes nationally authorised products rather than a centralised EU approval.

Evidence grade

L4Strong humanModerate confidence

Solid controlled human trials, though not yet definitive or fully replicated.

What would change our rating?

  • Not applicable at this evidence tier.

References and sources

Sources fully curated

Source hierarchy: regulatory documents and trial registries first, peer-reviewed work next, sponsor material flagged as non-independent. We never use supplier or clinic marketing as evidence, and where a verified source has not yet been curated we say so rather than inventing one.

Evidence change history

No recorded changes yet. Baseline position set on 2026-08-23.