Vasostrict Generic Name & Formulations
Vasopressin 20U/mL; soln for IV inj after dilution; 0.2U/mL, 0.4U/mL, 0.6U/mL; per premixed vial; soln for IV inj.
Single-dose vials (1mL)—10, 25; Multi-dose vial (10mL)—1; Premixed single-dose vials (100mL)—10
Mechanism of Action
Vasopressin causes vasoconstriction by binding to V1 receptors on vascular smooth muscle coupled to the Gq/11-phospholipase C-phosphatidyl-inositol-triphosphate pathway, resulting in the release of intracellular calcium. In addition, vasopressin stimulates antidiuresis via stimulation of V2 receptors which are coupled to adenyl cyclase.
To increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines.
Vasostrict Dosage and Administration
Use lowest effective dose. Post-cardiotomy shock: initially 0.03U/min; max 0.1U/min. Septic shock: initially 0.01U/min; max 0.07U/min. May titrate up by 0.005U/min at 10–15min intervals until target BP is achieved. After target BP maintained for 8hrs without use of catecholamines, taper by 0.005U/min every hour as tolerated to maintain target BP.
Multi-dose vial: chlorobutanol allergy.
Vasostrict Boxed Warnings
Decrease in cardiac index may be observed. Reversible diabetes insipidus. Monitor serum electrolytes, fluid status, and urine output after discontinuation. Elderly. Pregnancy (2nd & 3rd trimester: may need to increase dose). Nursing mothers.
Renal (minor). Half-life: ≤10 minutes.
Additive effect with concomitant catecholamines; monitor and adjust vasopressin dose as needed. May be potentiated by indomethacin, ganglionic blocking agents, SSRIs, tricyclics, haloperidol, chlorpropamide, enalapril, methyldopa, pentamidine, vincristine, cyclophosphamide, ifosfamide, felbamate; monitor and adjust vasopressin dose as needed. May be antagonized by demeclocycline, lithium, foscarnet, clozapine; monitor and adjust vasopressin dose as needed.
Vasostrict Adverse Reactions
Decreased cardiac output, bradycardia, tachyarrhythmias, hyponatremia, ischemia (coronary, mesenteric, skin, digital).
Vasostrict Clinical Trials
Vasostrict Patient Counseling