Vasopressin
Indications
Vasopressin is used for:
Initial control of variceal bleeding, Cranial diabetes insipidus, Abdominal Distention
Adult Dose
Intravenous
Initial control of variceal bleeding
Adult: 20 units in 100 ml of glucose 5% infused over 15 min.
Parenteral
Cranial diabetes insipidus
Adult: 5-20 units SC/IM every 4 hr.
Abdominal Distention
Adult: 5 units IM initially; repeated q3-4hr PRN; may be increased to 10 units
Hepatic impairment: Lower doses may be required to achieve response
Child Dose
Renal Dose
Administration
IV Preparation
Infusion: Dilute to 0.1-1 unit/mL with NS or D5W
IV/IM Administration
Administered SC or IM or by continuous IV or intra-arterial infusion via controlled infusion device
Contra Indications
Hypersensitivity. Vascular disease especially coronary artery disease; chronic nephritis (until reasonable blood-nitrogen conc attained).
Precautions
Heart failure; migraine; epilepsy; asthma or other conditions which might be exacerbated by fluid retention; renal impairment; hypertension or other conditions that may worse with BP increase. Adjust fluid intake to avoid fluid overload. Lactation, pregnancy (especially 3rd trimester as it may have oxytocic effect).
Pregnancy-Lactation
Pregnancy category: C
Lactation: Unknown whether drug is distributed into breast milk; use with caution
Interactions
Carbamazepine, chlorpropamide, clofibrate, urea, fludrocortisone and tricyclic antidepressants may potentiate the antidiuretic action of vasopressin. Demeclocycline, noradrenaline, lithium, heparin and alcohol may decrease antidiuretic action of vasopressin. Ganglionic blockers may increase sensitivity to the pressor effect of vasopressin. Increased risk of QT prolongation with dolasetron.
Side Effects
Side effects of Vasopressin :
Frequency Not Defined
Abdominal cramps
Allergic reaction
Angina
Bronchial constriction
Circumoral pallor
Diarrhea
Nausea
Pounding in the head
Sweating
Tremor
Uterine contraction
Vertigo
Mode of Action
Vasopressin is a posterior pituitary hormone which may be synthetically prepared or extracted from animals. It exerts direct antidiuretic action on the kidneys by increasing tubular reabsorption of water. Vasopressin also acts by constricting the peripheral blood vessels and causes the smooth muscle of the intestine, gall bladder and urinary bladder to contract. Vasopressin is given parenterally or intranasally in the form of argipressin or lypressin. Argipressin is a synthetic type of vasopressin derived from most mammals (including man but excluding pig) while lypressin is vasopressin from pig.