Terlipressin Dosage
Medically reviewed by Drugs.com. Last updated on Apr 3, 2023.
Applies to the following strengths: 0.85 mg preservative free
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Hepatorenal Syndrome
Initial dose:
Day 1 to 3:
0.85 mg IV bolus injection every 6 hours over a period of two minutes
Day 4:
- If serum creatinine (SCr) has decreased by 30% or more from baseline:
- If SCr has decreased by less than 30% from baseline:
Duration of therapy: Until 24h after patient achieves a second consecutive SCr value of less than or equal to 1.5 mg/dL at least 2 hours apart or for a maximum of 14 days
Comments:
- Monitor oxygen saturation using continuous pulse oximetry.
- Obtain baseline oxygen saturation prior to starting therapy.
- Record the serum creatinine (baseline SCr) value prior to starting treatment.
- Assess serum creatinine (SCr) versus baseline prior to starting day 4 treatment.
- If SCr is at or above the baseline value after the third day of treatment, stop therapy with this drug.
Use: To improve kidney function in adults with hepatorenal syndrome
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
No adjustment recommended.
Precautions
US BOXED WARNING:
SERIOUS OR FATAL RESPIRATORY FAILURE
- Serious or fatal respiratory failure may occur with the use of this drug.
- Patients with volume overload or acute-on-chronic liver failure (ACLF) grade 3 are more likely to have respiratory failure.
- Assess oxygenation saturation (e.g., SpO2) prior to starting treatment with this drug.
- Do not administer this drug to hypoxic patients (e.g., SpO2 less than 90%) until their oxygen levels improve.
- Monitor for hypoxia using continuous pulse oximetry during treatment and stop therapy with this drug if SpO2 decreases below 90%.
CONTRAINDICATIONS:
- Coronary, peripheral or mesenteric ischemia.
- Hypoxia or worsening respiratory symptoms.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Administer this drug through a peripheral or central line.
- Determine acute or chronic liver failure (ACLF) grade and volume status before beginning treatment with this drug.
- Treatment with this drug is not recommended in patients experiencing hypoxia until the hypoxia resolves.
- Visually inspect the drug solution for the presence of particulate matter and discoloration prior to administration.
Storage requirements:
- Refrigerate unopened vial at 2C to 8C (36F to 46F) in original carton to protect from light.
- Store reconstituted solution at 2C to 8 C (36F to 46 F) to use within 48 hours, if not used at once.
- Do not freeze.
Reconstitution technique:
- Reconstitute each vial with 5 mL of 0.9% Sodium Chloride Injection to prepare a 0.85 mg/5 mL solution.
General:
- In the event of an overdose, monitor vital signs, electrolytes, and potential ischemic events and administer symptomatic treatment.
- Patients with serum creatinine levels greater than 5 mg/dL are unlikely to benefit from this drug.
- Baseline SCr is the last available serum creatinine before starting treatment.
Monitoring:
Respiratory: Respiratory status (Oxygen saturation, Hypoxia)
Renal: Serum Creatinine
Metabolism: Hyponatremia, hypokalemia, hypomagnesemia, electrolyte disturbances
Patient advice:
- Notify your health care provider of a known or suspected pregnancy.
- This drug has the potential to cause fetal harm.
More about terlipressin
- Check interactions
- Compare alternatives
- Side effects
- During pregnancy
- Drug class: antidiuretic hormones
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