vasopressin (Rx)

Brand and Other Names:Vasostrict, ADH
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection solution

  • 20 units/mL

Abdominal Distention

5 units IM initially; repeated q3-4hr PRN; may be increased to 10 units

Diabetes Insipidus

5-10 units IM/SC q8-12hr

Titrate dose on basis of serum sodium, serum osmolality, fluid balance, and urine output

Abdominal Roentgenography

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

Dosage Modifications

Hepatic impairment: Lower doses may be required to achieve response

Gastrointestinal Hemorrhage (Off-label)

0.2-0.4 unit/min IV initially; may be increased to 0.8 unit/min IV PRN

Vasodilatory Shock (Off-label)

0.01-0.04 unit/min IV

Dosage Forms & Strengths

injection solution

  • 20 units/mL

Abdominal Distention

Proportionately reduced adult dosage

Diabetes Insipidus

2.5-10 units IM/SC/intranasally q8-12hr

Continuous IV infusion: 0.0005 unit/kg/hr initially, then double dose q30min to reach desired effect; not to exceed 0.01 unit/kg/hr  

Titrate dose on basis of serum sodium, serum osmolality, fluid balance, and urine output

Gastrointestinal Hemorrhage (Off-label)

0.3 units/kg IV; not to exceed 20 units  

0.002-0.005 unit/kg/min IV initially; may be increased to 0.01 unit/kg/min IV PRN  

If bleeding controlled for 12-24 hr, taper off over 24-36 hr

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Interactions

Interaction Checker

and vasopressin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (0)

                  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

                    urea increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.

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                  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

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                  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
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                  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.

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                  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%)

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                  Administration

                  IV Compatibilities

                  Additive: Verapamil

                  Y-site: Amiodarone, diltiazem, dobutamine, dopamine, epinephrine, heparin, lidocaine, milrinone, nitroglycerin, norepinephrine, phenylephrine, procainamide

                  IV Preparation

                  Infusion: Dilute to 0.1-1 unit/mL with NS or D5W

                  IV/IM Administration

                  Administered SC or IM or by continuous IV or intra-arterial infusion via controlled infusion device

                  Storage

                  Clear, colorless, or nearly colorless solution

                  Unopened vials

                  • 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)
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                  Images

                  BRAND FORM. UNIT PRICE PILL IMAGE
                  Vasostrict intravenous
                  -
                  20 unit/mL vial
                  Vasostrict intravenous
                  -
                  20 unit/mL vial
                  Vasostrict intravenous
                  -
                  20 unit/mL vial

                  Copyright © 2010 First DataBank, Inc.

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                  Patient Handout

                  Patient Education
                  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) 2021 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.

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                  Formulary

                  FormularyPatient Discounts

                  Adding plans allows you to compare formulary status to other drugs in the same class.

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                  Adding plans allows you to:

                  • View the formulary and any restrictions for each plan.
                  • Manage and view all your plans together – even plans in different states.
                  • Compare formulary status to other drugs in the same class.
                  • Access your plan list on any device – mobile or desktop.

                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.