Vasopressin
General
- Type: Vasopressors
- Dosage Forms:
- Common Trade Names: Vasostrict (USA)
Adult Dosing
Dosing
- 0.01-0.04 units/min (typically 0.03 or 0.04 U/min)
Rate of Titration
- Fixed dose (do not titrate)
Pediatric Dosing
0.0002–0.008 U/kg/min have been studied although no current consensus on dosage [1]
Special Populations
- Pregnancy Rating: C
- Lactation:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
- Bradycardia
- Limb ischemia
- Myocardial ischemia
- Splanchnic ischemia
Pharmacology
- Half-life: <20 minutes [2]
- Metabolism: liver, kidney extensively; CYP450: unknown
- Excretion: urine (5-6% unchanged)
- Mechanism of Action: "directly stimulates V1 and V2 receptors, resulting in vasoconstriction and antidiuresis" [3]
Primary Receptor
- V1
Relative Effects
- ↑SVR
- ↓HR
Notes
- Adverse effects are dose-dependent
- Acts on V1 receptors leading to ↑vasoconstriction and
- ↑sensitivity to catecholamines in patients with shock
- in contrast to catecholamine vasopressors (e.g. epinephrine, norepinephrine), vasopressin does not lose efficacy at low pH
Indication
- Adjunct for septic shock VASST trial [4]
- no difference in mortality when vasopressin was added as second line pressor compared to norepinephrine
- subgroup analysis found that patients with less severe septic shock did better with vasopressin
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Sepsis (main) | 0.03 units/min (fixed dose) | 2nd line vasopressor, added to norepinephrine | IV drip | Adult |
| Vasopressors | 0.03 U/min (fixed dose), max 0.04 U/min | 2nd line vasopressor | IV drip | Adult |
| Vasopressors | 0.03-0.04 units/min (fixed dose, do not titrate) | Adjunctive vasopressor; catecholamine-sparing | IV | Adult |