RT Journal Article SR Electronic T1 Is there a role for carbetocin in the prophylaxis of postpartum obstetric haemorrhage? JF Drug and Therapeutics Bulletin JO Drug Ther Bull FD BMJ Publishing Group Ltd SP 136 OP 140 DO 10.1136/dtb.2021.000030 VO 60 IS 9 A1 Andrea Day A1 Philip Barclay A1 Louise Page YR 2022 UL http://dtb.bmj.com/content/60/9/136.abstract AB Postpartum haemorrhage is a common complication of pregnancy, most commonly due to uterine atony. Uterotonics have a vital role in preventing postpartum haemorrhage but the choice of the most effective agent with the fewest adverse effects is a subject of debate. Carbetocin, a synthetic analogue of oxytocin has been available in the UK since 2007 but is not currently widely used. It has a longer duration of action than oxytocin, which avoids the need for an infusion and as it is heat-stable it can be stored at room temperature. Current UK clinical guidelines, based on the results of older meta-analyses, do not recommend carbetocin as a first-line agent. A Cochrane review, published in 2018, ranked carbetocin in the top three drug regimens for preventing postpartum haemorrhage and an international consensus statement on uterotonic use for caesarean birth concluded that carbetocin may become the preferred drug for caesarean birth, by reducing the need for additional uterotonics. The higher cost of carbetocin when compared with oxytocin is a limiting factor, but the significant healthcare costs of a postpartum haemorrhage and the physiological impact of this event suggests it a reasonable alternative to consider, especially if ergometrine is contraindicated or in those who are undergoing a caesarean birth or are at high risk of bleeding.