Terlipressin
Mechanism :
Terlipressin, a synthetic triglycyl-lysine derivative of vasopressin, is an inactive prodrug. It has pressor and antidiuretic effects. Following IV injection, lysine vasopressin is released following the enzymatic cleavage of 3 glycyl moieties.
Indication :
- Acute oesophageal variceal haemorrhage
- Refractory septic shock
Contraindications :
Hypersensitivity, vascular disease esp coronary artery disease, chronic nephritis (until normal blood-nitrogen concentration attained). Pregnancy.
Dosing :
Adult:
The initial recommended dose is 2 mg IV, then 1 or 2 mg 4-6 hourly until bleeding is controlled, up to 72 hour.
Adverse Effect :
Abdominal cramps, cardiac arrhythmias, headache, transient blanching, increased arterial pressure. Potentially Fatal: myocardial infarction, cardiac failure.
Interaction :
Drug Interactions Not Available.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function. Use with caution |
| <10 | Dose as in normal renal function. Use with caution |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unknown dialysability. Dose as in GFR<10 mL/min |
| HD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR<10 mL/min |
Hepatic Dose :
No dosage adjustments are recommended.