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Vasopressin Analogue Pregnancy: Contraindicated — vasoconstrictive effects on placenta

Terlipressin

Brand names: Glypressin

Adult dose

Dose: Oesophageal variceal haemorrhage: 2 mg IV bolus every 4–6 hours for up to 5 days. Hepatorenal syndrome: 0.5–2 mg IV every 4–6 hours.
Route: IV slow bolus
Frequency: Every 4–6 hours
Max: 2 mg per dose
For acute variceal haemorrhage (use with broad-spectrum antibiotics and terlipressin together with endoscopy). For hepatorenal syndrome type 1: terlipressin + albumin.

Paediatric dose

Dose: 0.05 mg/kg
Route: IV slow bolus over 1 minute
Frequency: Every 4–6 hours
Max: 2 mg per dose
Concentration: 1 mg/5 mL or 0.2 mg/mL mg/ml
Off-label paediatric use: 0.05 mg/kg (max 2 mg) IV every 4h for variceal bleeding. Specialist hepatology only.

Dose adjustments

Renal

Caution — may exacerbate renal impairment in some settings. In HRS: aim to improve renal function.

Hepatic

No dose adjustment required; main indication is in hepatic disease

Paediatric weight-based calculator

Off-label paediatric use: 0.05 mg/kg (max 2 mg) IV every 4h for variceal bleeding. Specialist hepatology only.

Clinical pearls

  • ATLAS study: terlipressin superior to vasopressin for variceal haemorrhage with better safety profile
  • For hepatorenal syndrome: terlipressin + 20% albumin (1 g/kg day 1 then 20–40 g/day) is standard — CONFIRM trial
  • Monitor ECG and BP closely — peripheral ischaemia can be severe, especially in vascular disease
  • Start alongside ceftriaxone 1 g/day prophylaxis for SBP in acute variceal bleeding (Baveno guidelines)

Contraindications

  • Ischaemic heart disease or peripheral vascular disease (strong relative)
  • Pregnancy
  • Severe asthma or bronchospasm
  • Epilepsy

Side effects

  • Pallor (cutaneous vasoconstriction)
  • Abdominal cramps
  • Hypertension
  • Bradycardia
  • Peripheral ischaemia
  • Myocardial ischaemia
  • Hyponatraemia (water retention)

Interactions

  • Beta-blockers — additive bradycardia
  • QT-prolonging drugs — increased risk
  • Non-selective NSAIDs — impair renal function

Monitoring

  • Blood pressure and heart rate
  • ECG (ischaemia, arrhythmia)
  • Peripheral perfusion
  • Urine output (in HRS: target improvement in creatinine)
  • Sodium levels

Reference: BNFc; BNF; Baveno VII Consensus 2022; CONFIRM Trial (Wong et al, NEJM 2021). Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.