Vasopressin analogue
Terlipressin acetate
Brand names: Glypressin, Variquel
Adult dose
Dose: Variceal bleed: 2mg IV bolus then 1–2mg every 4–6h up to 5 days. Hepatorenal syndrome: 1–2mg every 4–6h
Route: IV
Frequency: q4-6h
Clinical pearls
- Acute variceal bleeding (with antibiotics + endoscopy); hepatorenal syndrome type 1
- Inpatient cardiac monitoring
Contraindications
- Severe coronary/peripheral vascular disease
- Pregnancy
- Hypersensitivity
Side effects
- Peripheral / coronary / mesenteric ischaemia
- Bradycardia
- Hyponatraemia
- Skin necrosis if extravasation
- Hypertension
Interactions
- β-blockers (additive bradycardia)
- Other vasopressors
Monitoring
- BP
- HR
- Na+
- Symptoms of ischaemia
Reference: BNF; NICE CG141; UK guidelines; https://bnf.nice.org.uk/drugs/terlipressin-acetate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021