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Terlipressin for Injection
Composition:
Each vial contains:
- Terlipressin Acetate equivalent to Terlipressin 1mg or 2mg
- Excipients: (e.g., sodium chloride, water for injection)
Description:
Terlipressin is a vasopressin analog with potent vasoconstrictive effects. It is primarily used in emergency settings for conditions related to circulatory shock and portal hypertension.
Indications:
Terlipressin for Injection is indicated for:
- Bleeding esophageal varices (BEV) in patients with liver cirrhosis
- Hepatorenal syndrome (HRS) Type 1
- Refractory hypotension in septic shock (off-label use)
Dosage & Administration:
For Bleeding Esophageal Varices (BEV):
- Initial dose: 2mg IV bolus every 4-6 hours
- Maintenance dose: 1mg IV every 4-6 hours until bleeding control (max 48 hours)
For Hepatorenal Syndrome (HRS Type 1):
- Initial dose: 0.5-1mg IV every 4-6 hours
- Titration: Increase up to 2mg every 4 hours if no response after 3 days
- Duration: Usually 3-14 days, depending on kidney function improvement
Administration:
- Given intravenously (IV) by slow injection over 2-5 minutes
- Can be diluted in normal saline (NS) or dextrose 5% (D5W)
Contraindications:
- Hypersensitivity to Terlipressin or vasopressin analogs
- Severe cardiac disease (e.g., coronary artery disease, uncontrolled hypertension)
- Severe peripheral vascular disease
- Pregnancy (Category C) - Risk of uterine contractions and fetal distress
Precautions:
- Cardiovascular risks: May cause bradycardia, arrhythmias, or severe hypertension.
- Renal monitoring: Monitor urine output and kidney function.
- Electrolyte imbalance: May cause hyponatremia or hypokalemia.
- Use in elderly patients: Increased risk of ischemic events.
Adverse Reactions:
- Common: Abdominal cramps, nausea, diarrhea, paleness, headache
- Cardiovascular: Hypertension, bradycardia, arrhythmias
- Serious (rare): Myocardial infarction, mesenteric ischemia, peripheral ischemia
Drug Interactions:
- Diuretics: Increased risk of hyponatremia.
- Dopamine or norepinephrine: Risk of excessive vasoconstriction.
Storage Conditions:
- Store below 25°C.
- Protect from light and moisture.
- Reconstituted solution should be used immediately.
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