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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
terlipressin
H01BA04
Forms & Strengths
- Intravenous solution: 0.85 mg / 8.5 mL (equivalent to 1 mg terlipressin acetate)
Adult Dosing
- Hepatorenal syndrome (HRS) type 1: 1 mg IV every 6 hours for up to 14 days
- Dose may be increased to 2 mg every 6 hours if serum creatinine does not decrease by at least 30% from baseline on Day 4
- Discontinue therapy if serum creatinine reaches < 1.5 mg/dL or if severe adverse reactions occur
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Improvement of renal function in adults with hepatorenal syndrome (HRS) with a rapid reduction in renal function
Mechanism of Action
- Synthetic analog of vasopressin acting as a selective vasopressin V1 receptor agonist
- Constricts visceral blood vessels, reducing portal blood flow and portal pressure
- Increases effective circulating volume and renal perfusion pressure in patients with hepatorenal syndrome
Contraindications
- Patients with hypoxia or worsening respiratory symptoms
- Patients with ongoing coronary ischemia
- Hypersensitivity to terlipressin or vasopressin
- Pregnancy
Adverse Reactions
- Respiratory failure and acute respiratory distress syndrome (ARDS)
- Abdominal pain and nausea
- Diarrhea
- Bradycardia
- Hypertension and hypertensive crisis
- Ischemia (peripheral, mesenteric, or myocardial)
Drug Interactions
- Concomitant use with drugs that decrease heart rate (e.g., beta-blockers, non-dihydropyridine calcium channel blockers) may exacerbate bradycardia
- Concomitant use with potent vasoconstrictors may increase the risk of ischemic events
Curated Content: Needs Vetting Before Put to Clinical Use