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Vasopressin

(Vasostrict®)

Vasostrict®

Drug updated on 9/4/2024

Dosage FormInjection (intravenous; 20 units/mL, 200 units/10 mL [20 units/mL], 20 units/100 mL [0.2 units/mL], 40 units/100 mL [0.4 units/mL], and 60 units/100 mL [0.6 units/mL])
Drug ClassAntidiuretic hormones
Ongoing and
Completed Studies		ClinicalTrials.gov

Indication

  • Indicated to increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines.

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Summary
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  • Vasostrict (vasopressin) is indicated to increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines.
  • This summary is based on the review of five systematic review(s)/meta-analysis(es). [1-5]
  • Cardiac Arrest: Return of Spontaneous Circulation (ROSC) - Vasopressin combined with methylprednisolone significantly increased ROSC compared to placebo (RR = 1.32; 95% CI = [1.18, 1.47], p < 0.00001).
  • Septic Shock: Vasopressin vs. Norepinephrine - Vasopressin significantly reduced the odds of requiring renal replacement therapy (OR = 0.68; CI = [0.47, 0.98]), with no significant differences in 28-day mortality, ICU mortality, length of ICU stay, length of hospital stay, mean arterial pressure at 24 hours, urine output at 24 hours, and serious adverse events compared to norepinephrine.
  • Septic Shock: Vasopressin as an Adjuvant - Vasopressin and its synthetic variants (Terlipressin, Selepressin) are more effective as adjuvant agents compared to Dopamine and Dobutamine when used with Noradrenaline.
  • No specific safety outcomes or adverse effects were mentioned for vasopressin and methylprednisolone in the context of in-hospital cardiac arrest.
  • In septic shock, vasopressin showed no significant differences in adverse effects compared to norepinephrine, but digital ischemia was reported as an adverse effect when vasopressin was used in high doses. Novel vasopressors (Angiotensin II, Selepressin, Terlipressin) were associated with specific safety concerns, including thromboembolism and ischemia.
  • There is no population information available in the reviewed studies.