Carbetocin
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Carbetocin: From Prader-Willi Syndrome to Isotretinoin-like Syndrome
One-Sentence Summary
Carbetocin is an oxytocin receptor agonist. It is registered in Singapore as an injectable and is used to prevent postpartum haemorrhage due to uterine atony. Its knowledge-graph indications are Prader-Willi syndrome and Noonan syndrome. The TxGNN model predicts it may be effective for isotretinoin-like syndrome, but no clinical trials and no relevant publications currently support this prediction. This is a model-only prediction (Evidence Level L5).
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Prader-Willi syndrome, Noonan syndrome (knowledge-graph indications; the Singapore licence has no approved indication text recorded) |
| Predicted New Indication | Isotretinoin-like syndrome |
| TxGNN Prediction Score | 99.15% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 1 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available in the data compiled for this report. Pharmacology data identifies carbetocin as a peptide agonist of the oxytocin receptor (OXTR). It is used to prevent postpartum haemorrhage due to uterine atony. An intranasal formulation (LV-101) has been in development for hyperphagia in Prader-Willi syndrome.
No plausible link between oxytocin receptor agonism and isotretinoin-like syndrome, a congenital malformation syndrome, could be verified from the available data. The high score (0.991) most likely reflects graph-based similarity to other congenital syndromes rather than a validated biological mechanism. The model ranked this prediction 9,415th overall, so the score should be interpreted cautiously.
Among the other top-ranked predictions, two have a more coherent rationale and are flagged as research questions:
- Prader-Willi syndrome due to paternal deletion of 15q11q13 (score 99.0%): a molecular subtype of an existing indication. The oxytocin system is plausibly involved, since oxytocin-producing neurons in the hypothalamus are reduced in this condition.
- Partial deletion of the long arm of chromosome 15 (score 98.9%): this may overlap the 15q11-q13 region, but the phenotype depends on the exact deleted region.
The remaining top-10 predictions (Goodman syndrome, brachymorphism-onychodysplasia-dysphalangism syndrome, Mietens syndrome, hydrocephalus-costovertebral dysplasia-Sprengel anomaly syndrome, lethal faciocardiomelic dysplasia, symptomatic Coffin-Lowry syndrome in female carriers, and hypoglossia-hypodactyly syndrome) have no clinical or literature support and no verifiable mechanism.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available for isotretinoin-like syndrome.
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN15173P | DURATOCIN RTS SOLUTION FOR INJECTION 100 MCG/ML (Ferring GmbH) | Injection, solution | Not recorded in the data compiled for this report |
Safety Considerations
- Drug Interactions: The interaction query found only a pharmacological target relationship (oxytocin receptor, OXTR), not a drug-drug interaction. No interacting drugs were identified.
- Cardiac signal (from a case report on a different topic): One retrieved case report described chest pain and electrocardiographic signs of myocardial ischaemia right after carbetocin was given during a caesarean delivery, in a patient with an anomalous right coronary artery. It is a single case, but it suggests cardiovascular caution.
Package insert warnings and contraindications were not available. Please refer to the package insert for safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction for isotretinoin-like syndrome rests only on a graph-based score. There are no trials, no relevant publications, and no verifiable mechanism linking oxytocin receptor agonism to this condition. The three publications retrieved for the sixth-ranked prediction are keyword-matched noise (a bioinformatics study, an obstetric case report, a veterinary study). They do not support any new indication.
To proceed, the following is needed:
- Package insert warnings and contraindications from the HSA website, which block safety screening
- Mechanism of action data for carbetocin (for example, from DrugBank)
- A literature review specific to isotretinoin-like syndrome and the oxytocin pathway
- Route compatibility assessment, since the Singapore product is injectable and any new use may need a different route
- Consideration of the Prader-Willi 15q11q13 deletion subtype and 15q deletions as research questions, using evidence from the parent Prader-Willi indication and external sources
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.