৳ 3,000/unit
Pack: ৳ 3,000
৳ 3,000/unit
Pack: ৳ 3,000
At a glance
Terlipressin is a vasopressin analog used for the short-term management of bleeding esophageal varices and type 1 hepatorenal syndrome. It controls bleeding by reducing splanchnic blood flow and portal pressure.
Indications
- Bleeding esophageal varices (short-term management)
- Type 1 hepatorenal syndrome (IAC criteria)
Pharmacology
Terlipressin is a prodrug converted to lysine-vasopressin, which activates V1 receptors. It reduces splanchnic blood flow, decreases portal pressure, increases systemic arterial pressure, and decreases heart rate. Minimal V2 receptor activity results in low antidiuretic effects.
Dosage
Adult Dose (IV):
- Bleeding esophageal varices: Start 2 mg every 4 hours (until bleeding controlled for 24 hours, max 48 hours); <50 kg or adverse effects: 1 mg every 4 hours
- Type 1 hepatorenal syndrome: 3-4 mg every 24 hours (3-4 administrations); if serum creatinine not reduced by 25% after 3 days, discontinue; target: creatinine <130 µmol/L or ≥30% reduction; average treatment 10 days
Side effects
Common Side Effects:
- Paleness (skin)
- Increased blood pressure
- Abdominal pain, nausea, diarrhea
- Headache
- Abdominal cramps
Serious:
- QT prolongation, Torsade de pointes
- Bradycardia
- Cardiac arrhythmias
Use in pregnancy
Use in Pregnancy: Highly unsafe; may cause uterine contractions and decreased fetal blood flow; do not use; consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Do not use in unstable angina, recent MI, septic shock with low cardiac output
- Caution in hypertension, heart disease, renal dysfunction, cerebrovascular disease
- Monitor ECG, BP, HR, electrolytes, and fluid balance during treatment
- Caution with QT-prolonging drugs
Overdose effects
Overdose may cause severe circulatory adverse effects; elevated BP can be controlled with clonidine 150 mcg IV; bradycardia treated with atropine.
Storage conditions
Store at 2-8°C in a refrigerator, protected from light in the original carton; keep out of reach of children.