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SYSTEMIC HORMONAL PREPARATIONS, EXCL. SEX HORMONES AND INSULINS › PITUITARY AND HYPOTHALAMIC HORMONES AND ANALOGUES › POSTERIOR PITUITARY LOBE HORMONES › Vasopressin and analogues
vasopressin (argipressin)
H01BA01
Forms & Strengths
- Injection: 20 units/mL
- Solution for injection: 1 mL ampoules, 10 mL vials
Adult Dosing
- Cardiac arrest: 40 units IV (1 mL of 20 units/mL solution) one time
- Vasodilatory shock: 0.01-0.1 units/min IV infusion, titrate to effect
- Diabetes insipidus: 5-10 units IM or SC, 2-4 times a day
Pediatric Dosing
- Cardiac arrest: 0.4-1 units/kg IV (0.02-0.05 mL/kg of 20 units/mL solution), not to exceed 40 units
- Diabetes insipidus: 2.5-5 units IM or SC, 2-4 times a day
Indications
- Cardiac arrest, unresponsive to epinephrine
- Vasodilatory shock (e.g. post-cardiotomy or septic shock) unresponsive to norepinephrine or epinephrine
- Diabetes insipidus
- Gastrointestinal bleeding (optional, off-label)
Mechanism of Action
- V1 receptor agonist: promotes arterial vasoconstriction
- V2 receptor agonist: stimulates water and electrolyte absorption in renal tubules
Contraindications
- Chronic nephritis
- Allergic reaction to vasopressin
- Known heart disease (caution in coronary artery disease, heart failure), arrhythmias
Adverse Reactions
- Hypertension, cardiac arrhythmias, cardiac arrest
- Skin necrosis at injection site
- Abdominal cramps, nausea, vomiting, diarrhea
- Anaphylaxis
Drug Interactions
- Indomethacin, beta-blockers: may enhance adverse effects on the cardiovascular system
- Ganglion blockers: may enhance or reduce effects of vasopressin
- Phentolamine: may reduce effectiveness of vasopressin
Curated Content: Needs Vetting Before Put to Clinical Use