Vasostrict

Drug overview for VASOSTRICT (vasopressin):

Generic name: VASOPRESSIN
Drug class: Antidiuretic Hormone
Therapeutic class: Endocrine

Vasopressin (antidiuretic hormone) is a polypeptide hormone secreted by the neurons of the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior pituitary (neurohypophysis) in mammals; the primary physiologic role of vasopressin is to maintain serum osmolality within a normal range, but the hormone also causes vasoconstriction.

No enhanced Uses information available for this drug.

DRUG IMAGES

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The following indications for VASOSTRICT (vasopressin) have been approved by the FDA:

Indications:
Hypotension due to distributive shock

Professional Synonyms:
None.

The following dosing information is available for VASOSTRICT (vasopressin):

Dosing
Administration
Dosing Information
Generic

Vasopressin dosage requirements are variable and must be adjusted according to patient response. In order to avoid adverse effects, it is desirable to give doses that are just sufficient to elicit the desired response.

There is limited information regarding exposure of vasopressin in patients with hepatic impairment and no specific dosage recommendations are available for such patients; dosage should be titrated to effect.

There is limited information regarding exposure of vasopressin in patients with renal impairment and no specific dosage recommendations are available for such patients; dosage should be titrated to effect.

Vasopressin is administered by IV infusion for the management of vasodilatory shock. The drug also has been administered by IM+ or subcutaneous+ injection for other uses (e.g., postoperative abdominal distention, diabetes insipidus). Vasopressin also has been applied topically+ to the nasal mucosa (e.g., with a cotton pledget, nasal spray, or dropper) in the treatment of diabetes insipidus.

Vasopressin has been administered by intraosseous (IO)+ injection for advanced cardiovascular life support (ACLS)+, generally when IV access is not readily available; onset of action and systemic concentrations of the drug are comparable to those achieved with venous administration. Vasopressin also has been administered endotracheally+ when vascular (IV or IO) access cannot be established during cardiac arrest; however, IV or IO administration is preferred whenever possible because of more predictable drug delivery and pharmacologic effect. In addition, the drug has been administered by intra-arterial infusion+ in the management of GI hemorrhage+. Intra-arterial infusion of the drug requires specialized techniques, including angiographic placement of the catheter, and should only be performed by clinicians familiar with this method of administration and the management of potential complications.

No dosing information available.

No generic dosing information available.

The following contraindication information is available for VASOSTRICT (vasopressin):

Overview
Contraindicated
Severe
Moderate

Drug contraindication overview.

No enhanced Contraindications information available for this drug.

There are 1 contraindications. Absolute contraindication.

Contraindication List
Uremia

There are 2 severe contraindications. Adequate patient monitoring is recommended for safer drug use.

Severe List
Coronary artery disease
Hypertension

There are 4 moderate contraindications. Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.

Moderate List
Asthma
Heart failure
Migraine
Seizure disorder

More Frequent	Less Frequent
Hyponatremia Low cardiac output Myocardial ischemia Tachyarrhythmia	None.

Rare/Very Rare
Atrial fibrillation Bradycardia Diabetes insipidus Distal limb ischemia Gastrointestinal vascular ischemia Hemorrhage Hyperbilirubinemia Kidney disease with reduction in glomerular filtration rate (GFr) Peripheral ischemia Thrombocytopenic disorder

The following precautions are available for VASOSTRICT (vasopressin):

Pediatric
Pregnant
Lactation
Geriatric

No enhanced Pediatric Use information available for this drug.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

There are no adequate or well-controlled studies of vasopressin in pregnant women, and animal reproduction studies with the drug have not been conducted. It is not known whether vasopressin can cause fetal harm when administered to pregnant women or can affect reproduction capacity; the drug should be used during pregnancy only if the potential benefits justify the potential risks to a fetus. Vasopressin may produce tonic uterine contractions that could threaten the continuation of pregnancy.

Clearance of vasopressin is increased in the second and third trimester of pregnancy; dosages exceeding 0.1 units/minute may be required in patients with postcardiotomy shock and dosages exceeding 0.07 units/minute may be required in patients with septic shock.

It is not known whether vasopressin is distributed into human milk. Some manufacturers recommend that the drug be used with caution in nursing women. Oral absorption of vasopressin in a nursing infant is considered unlikely since the drug is rapidly destroyed in the GI tract.

Consideration may be given to advising a lactating woman to pump and discard her breast milk for 1.5 hours after receiving vasopressin to minimize potential exposure to the infant.

No enhanced Geriatric Use information available for this drug.

Hypotension due to distributive shock
A48.3	Toxic shock syndrome
E27.2	Addisonian crisis
I95	Hypotension
R65.21	Severe sepsis with septic shock
T78.2	Anaphylactic shock, unspecified
T78.2xxA	Anaphylactic shock, unspecified, initial encounter
T81.12	Postprocedural septic shock
T81.12xA	Postprocedural septic shock, initial encounter