Vasopressin

What it is and how it works

Mechanism of Action Vasopressin causes vasoconstriction by binding to V 1 receptors on vascular smooth muscle coupled to the Gq/1 1-phospholipase C-phosphatidyl-inositol-triphosphate pathway, resulting in the release of intracellular calcium. In addition, vasopressin stimulates antidiuresis via stimulation of V 2 receptors which are coupled to adenyl cyclase.

Indications

Vasopressin injection is indicated to increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. • Vasopressin injection is indicated to increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines.

Dosage and administration (summary)

• Dilute 20 units/mL single dose vial contents with normal saline (0.9% sodium chloride) or 5% dextrose in water (D5W) to either 0.1 units/mL or 1 unit/mL for intravenous administration. Discard unused diluted solution after 18 hours at room temperature or 24 hours under refrigeration. • Post-cardiotomy shock: 0.03 to 0.1 units/minute • Septic shock: 0.01 to 0.07 units/minute Preparation of Solution Inspect parenteral drug products for particulate matter and discoloration prior to use, whenever solution and container permit.

Contraindications

Vasopressin injection 1 mL single dose vial does not contain chlorobutanol and is therefore contraindicated only in patients with a known allergy or hypersensitivity to 8-L-arginine vasopressin. • Vasopressin injection 1 mL single dose vial does not contain chlorobutanol and is therefore contraindicated only in patients with a known allergy or hypersensitivity to 8-L-arginine vasopressin.

Warnings and precautions

• Can worsen cardiac function. • Reversible diabetes insipidus Worsening Cardiac Function A decrease in cardiac index may be observed with the use of vasopressin. Reversible Diabetes Insipidus Patients may experience reversible diabetes insipidus, manifested by the 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.

Pregnancy

Pregnancy Risk Summary There are no available data on Vasopressin injection use in pregnant women to inform a drug associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Animal reproduction studies have not been conducted.

Storage and supply

Vasopressin injection, USP is a clear, practically colorless solution for intravenous administration available as: Product Code Unit of Sale Strength Unit of Use 930101 NDC 63323-930-01 A tray of 25 Single Dose Vials 20 Units per 1 mL NDC 63323-930-00 1 mL Single Dose Vial Store between 2°C and 8°C (36°F and 46°F). Do not freeze.

Source: Vasopressin (Vasopressin) — US FDA prescribing information, 2025-02-15, DailyMed. Summarised and shortened; the full label governs. Iranian registration, indications and labelling may differ.