Carbetocin is a long-acting synthetic analog of oxytocin (MW ~1041.2 g/mol) with a half-life of approximately 40 minutes, roughly 4-10 times longer than oxytocin. It is included on the WHO Model List of Essential Medicines for prevention of postpartum hemorrhage (PPH). Carbetocin is approved in over 30 countries for the prevention of uterine atony and PPH following cesarean delivery. A heat-stable formulation was developed to enable use in low-resource settings where cold chain maintenance is challenging.
Category: Reproductive / Hormonal. Evidence rating: A (strong human clinical data).
Clinical status: WHO Essential Medicine. Approved in over 30 countries for PPH prevention following cesarean section. Not FDA-approved in the United States.
Carbetocin is a modified oxytocin molecule in which the disulfide bridge is replaced by a thioether linkage (deamino-1-monocarba modification) and the tyrosine at position 2 is O-methylated. These structural changes confer resistance to enzymatic degradation by aminopeptidases and disulfidases,…
Safety considerations: Abdominal pain and uterine cramping (common); Nausea and vomiting; Facial flushing and sensation of warmth.
Reviewed by the PeptideAtlas Editorial Team. Last reviewed: 2026-08-12.
Related peptides: Kisspeptin, Gonadorelin, Oxytocin.
Compare: Carbetocin vs Kisspeptin, Carbetocin vs Gonadorelin, Carbetocin vs Oxytocin.
Carbetocin has a modified chemical structure that makes it resistant to enzymatic breakdown, giving it a half-life of about 40 minutes compared to 1-6 minutes for oxytocin. This means a single injection of carbetocin provides sustained uterine contraction, while oxytocin typically requires a continuous infusion for the same effect.
Carbetocin has not been submitted for or received FDA approval. In the US, oxytocin remains the standard of care for PPH prevention. Carbetocin is primarily used in Canada, Europe, Australia, and low-resource settings where its heat stability and single-dose administration offer logistical advantages.
The CHAMPION trial (NEJM 2018, n=29,645) was a WHO-sponsored, double-blind, non-inferiority trial conducted in 10 countries comparing heat-stable carbetocin to oxytocin for PPH prevention after vaginal delivery. It demonstrated non-inferiority and led to carbetocin being placed on the WHO Model List of Essential Medicines.