Angiotensin II (Human)

How it works

It is a synthetic form of the endogenous peptide hormone angiotensin II that acts on vascular angiotensin type 1 receptors to cause vasoconstriction and increase systemic vascular resistance.

Prescribing in practice

• There is an increased risk of arterial and venous thromboembolic events, so concurrent venous thromboembolism prophylaxis is recommended unless contraindicated.
• It is intended as add-on therapy alongside conventional vasopressors and should be administered in a critical care setting with continuous haemodynamic monitoring.
• Titrate to the target blood pressure response, reducing the rate as the patient stabilises, in line with the SPC.

Monitoring

Use continuous blood pressure and haemodynamic monitoring during the infusion and watch for thromboembolic complications.

Counselling the patient

• This is a critical care medicine used to support your blood pressure during severe illness.
• It is given through a drip and your blood pressure is monitored continuously.
• Measures to prevent blood clots are usually given alongside it.

Evidence & guidelines

The ATHOS-3 trial demonstrated that angiotensin II raised blood pressure in catecholamine-resistant distributive shock, supporting its use as an adjunctive vasopressor.