Dosing & Uses
Dosage Forms & Strengths
injection solution for dilution
- 20 units/mL (3-mL single-dose vial; 10-mL multidose vial); further dilution required /100mL
injection solution, ready-to-use
- 20 units/100mL (0.2 units/mL)
- 40 units/100mL (0.4 units/mL)
- 60 units/100mL (0.6 units/mL)
Vasodilatory Shock
Indicated to increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines
Titrate to lowest dose compatible with clinically acceptable response
Postcardiotomy shock (initial dose): 0.03 units/minute IV
Septic shock (initial dose): 0.01 unit/minute IV
Titrate up by 0.005 unit/minute at 10- to 15-minute intervals until target blood pressure reached
Data are limited data for doses >0.1 unit/minute for postcardiotomy shock and 0.07 unit/minute for septic shock; adverse reactions expected to increase with higher doses
After target blood pressure maintained for 8 hr without use of catecholamines, taper vasopressin injection by 0.005 units/minute every hour as tolerated to maintain target blood pressure
Dosage Modifications
Hepatic or renal impairment: No dosage adjustment provided in prescribing information
Abdominal Distention (Off-label)
5 units IM initially; repeated q3-4hr PRN; may be increased to 10 units
Diabetes Insipidus (Off-label)
5-10 units IM/SC q8-12hr
Titrate dose on basis of serum sodium, serum osmolality, fluid balance, and urine output
Abdominal Roentgenography (Off-label)
10 units (0.5mL) IM/SC 2 hours before procedure, then 10 units IM 30 minutes before procedure
May give enema prior to first dose of vasopressin
Gastrointestinal Hemorrhage (Off-label)
0.2-0.4 unit/min IV initially; may be increased to 0.8 unit/min IV PRN
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (1)
- methylphenidate transdermal
methylphenidate transdermal and vasopressin both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
Minor (24)
- amitriptyline
amitriptyline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- amoxapine
amoxapine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- carbamazepine
carbamazepine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- chlorpropamide
chlorpropamide increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- clomipramine
clomipramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- demeclocycline
demeclocycline decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.
- desipramine
desipramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- doxepin
doxepin increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- epinephrine
epinephrine decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.
- epinephrine racemic
epinephrine racemic decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.
- ethanol
ethanol decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- heparin
heparin decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.
- imipramine
imipramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- lithium
lithium decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.
- lofepramine
lofepramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- maprotiline
maprotiline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- mecamylamine
mecamylamine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- nortriptyline
nortriptyline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- phenformin
phenformin increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- protriptyline
protriptyline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- trazodone
trazodone increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- trimipramine
trimipramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- urea topical
urea topical increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Abdominal cramps
Allergic reaction
Angina
Bronchial constriction
Circumoral pallor
Diarrhea
Nausea
Pounding in the head
Sweating
Tremor
Uterine contraction
Vertigo
Postmarketing Reports
Reversible diabetes insipidus
Warnings
Contraindications
Hypersensitivity; multiple dose vial (10 mL) is contraindicated in patients with known allergy or hypersensitivity to 8-L-arginine vasopressin or chlorobutanol; the 1 mL single dose vial does not contain chlorobutanol; contraindicated only in patients with a known allergy or hypersensitivity to 8-L-arginine vasopressin
Cautions
With gastrointestinal (GI) bleeding, infusion should be continued for 12-24 hours after bleeding has stopped, and dosage should then be tapered over 24-48 hours
Continuous infusion should be administered via controlled infusion device
Use caution in chronic nephritis with nitrogen retention
Patients may experience reversible diabetes insipidus, manifested by development of polyuria, a dilute urine, and hypernatremia, after cessation of treatment with vasopressin; monitor serum electrolytes, fluid status and urine output after vasopressin discontinuation; some patients may require readministration of vasopressin or administration of desmopressin to correct fluid and electrolyte shifts
Pre- and postoperative patients with polyuria may occur
Use caution in patients with seizure, migraine, asthma, heart failure, vascular disease, angina pectoris, coronary thrombosis, renal disease
Use in pregnant women only when clearly needed
A decrease in cardiac index may be observed with the use of vasopressin
Drug interactions overview
- Use with catecholamines is expected to result in an additive effect on mean arterial blood pressure and other hemodynamic parameters; hemodynamic monitoring is recommended; adjust dose of vasopressin as needed
- Use with indomethacin may prolong effect of drug on cardiac index and systemic vascular resistance; hemodynamic monitoring is recommended; adjust dose of vasopressin as needed
- Use with ganglionic blocking agents may increase the effect of Vasostrict® on mean arterial blood pressure. Hemodynamic monitoring is recommended; adjust the dose of vasopressin as needed
- Use with drugs suspected of causing SIADH (eg, SSRIs, tricyclic antidepressants, haloperidol, chlorpropamide, enalapril, methyldopa, pentamidine, vincristine, cyclophosphamide, ifosfamide, felbamate) may increase pressor effect in addition to antidiuretic effect of drug; hemodynamic monitoring is recommended; adjust dose of vasopressin as needed
Pregnancy & Lactation
Pregnancy
There are no available data on use in pregnant women to inform a drug associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; animal reproduction studies not conducted
Dose may need adjustments during pregnancy and postpartum period due to increased clearance of vasopressin in the second and third trimester
Therapy may produce tonic uterine contractions that could threaten continuation of pregnancy
Lactation
There are no data on presence of vasopressin injection in either human or animal milk, effects on breastfed infant, or on milk production
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Vasoconstrictor without inotropic or chronotopic effects; stimulates smooth muscle in GI tract to cause peristalsis
Absorption
Bioavailability: Destroyed by trypsin in GI tract; must be administered parenterally or intranasally
Onset (antidiuretic activity): IM/SC, 2-8 hr
Onset (pressor activity) IV, 30-60 min
Metabolism
Metabolized in liver and kidney; rapidly removed from plasma
Elimination
Half-life: 10-20 min (parenteral)
Excretion: Urine (5-10%)
Administration
IV Compatibilities
Additive: Verapamil
Y-site: Amiodarone, diltiazem, dobutamine, dopamine, epinephrine, heparin, lidocaine, milrinone, nitroglycerin, norepinephrine, phenylephrine, procainamide
IV Preparation
Solution should appear clear, colorless, or nearly colorless
Dilution required for 20 units/mL vial to 0.1-1 unit/mL with NS or D5W before administration
Fluid restricted: Dilute 5 mL (100 units) in 100-mL IV bag to yield 1 unit/mL
Not fluid restricted: Dilute 2.5 mL (50 units) in 500-mL IV bag to yield 0.1 unit/mL
IV Administration
Administer by continuous IV or intra-arterial infusion via controlled infusion device
Storage
Unopened vials or premixed bottles
- Refrigerate at 2-8°C (36-46°F); do not freeze, OR
- Controlled room temperature 20-25°C (68-77°F) for 12 months or manufacturer expiration date (whichever is earlier); do not store above 25°C (77°F)
Opened vials (after first puncture)
- Once opened, may store for 48 hr
- Do not store above 25°C (77°F)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| vasopressin intravenous - | 20 unit/mL vial |  | |
| vasopressin intravenous - | 20 unit/mL vial |  | |
| vasopressin intravenous - | 20 unit/mL vial |  | |
| vasopressin intravenous - | 20 unit/mL vial |  | |
| vasopressin intravenous - | 20 unit/mL vial |  | |
| Vasostrict intravenous - | 20 unit/mL vial |  | |
| Vasostrict intravenous - | 20 unit/mL vial |  | |
| Vasostrict intravenous - | 20 unit/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
vasopressin intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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