Terlipressin

CLINICAL USE

Treatment of bleeding oesophageal varices

DOSE IN NORMAL RENAL FUNCTION

2 mg stat dose followed by 1–2 mg every 4–6 hours when required (until bleeding is controlled) for up to 72 hours

PHARMACOKINETICS

Molecular weight : 1227.4 (1437.6 as acetate)

%Protein binding : ≈30

%Excreted unchanged in urine : <2

Volume of distribution (L/kg) : 0.6–0.9

half-life – normal/ESRD (hrs) : 50–70 minutes

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function. Use with caution

<10 : Dose as in normal renal function. Use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unknown dialysability. Dose as in GFR <10 mL/min

HD : Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux : Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD : Unknown dialysability. Dose as in GFR <10 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

With solvent provided

Route

Rate of Administration

–

Comments

Store reconstituted solution in the fridge and discard after 12 hours

OTHER INFORMATION

Maximum plasma levels are reached after 1–2 hours with a duration of action of 4–6 hours Initial response within 25–40 minutes, duration 2–10 hours Some studies have found it can be used to improve renal function in hepatorenal syndrome, in doses of about 3 mg per day for about 11 days May cause hypertension There is a case report of rhabdomyolysis .

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