Formulary
Terlipressin acetate: Indications, Dosing, Side Effects and Interactions
Terlipressin acetate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Terlipressin acetate: Indications, Dosing, Side Effects and Interactions
Terlipressin acetate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Bleeding from oesophageal varices**
- **Adult** (By Intravenous Injection): (body-weight 70 kg and above) Initially 2 mg, then 1 mg every 4-6 hours for up to 72 hours.
**Type 1 hepatorenal syndrome**
- **Adult** (By Intravenous Injection): 1 mg every 4-6 hours, increased if necessary up to 2 mg every 4 hours for a usual total duration of 7 days (up to a max. of 14 days), dose to be increased if serum-creatinine does not decrease by at least 25% after 3 days, discontinue treatment when serum-creatinine falls below 133 micromol/litre (1.5 mg/dL).
**Adjunct in acute massive haemorrhage of gastro-intestinal tract or oesophageal varices (under expert supervision) for Glypressin injection**
- **Child 12-17 years (body-weight up to 50 kg)** (By intravenous injection): Initially 2 mg every 4 hours until bleeding controlled, then reduced to 1 mg every 4 hours if required, maximum duration 48 hours.
- **Child 12-17 years (body-weight 50 kg and above)** (By intravenous injection): Initially 2 mg every 4 hours until bleeding controlled, reduced if not tolerated to 1 mg every 4 hours, maximum duration 48 hours.
**Adjunct in acute massive haemorrhage of gastro-intestinal tract or oesophageal varices (under expert supervision) for Variquel injection**
- **Child 12-17 years (body-weight up to 50 kg)** (By intravenous injection): Initially 1 mg, then 1 mg every 4-6 hours for up to 72 hours.
- **Child 12-17 years (body-weight 50-69 kg)** (By intravenous injection): Initially 1.5 mg, then 1 mg every 4-6 hours for up to 72 hours.
- **Child 12-17 years (body-weight 70 kg and above)** (By intravenous injection): Initially 2 mg, then 1 mg every 4-6 hours for up to 72 hours.
Cautions
Arrhythmia; elderly; electrolyte and fluid disturbances; heart disease; history of QT-interval prolongation; respiratory disease; septic shock; uncontrolled hypertension; vascular disease
Side effects
Common or very common Abdominal cramps; arrhythmias; diarrhoea; headache; hypertension; hypotension; nausea; pallor; peripheral ischaemia; vasoconstriction Uncommon Chest pain; cyanosis; fluid overload; heart failure; hot flush; hyponatraemia; injection site necrosis; intestinal ischaemia; ischaemic heart disease; lymphangitis; myocardial infarction; pulmonary oedema; respiratory disorders; seizure; skin reactions; uterine ischaemia; vomiting Rare or very rare Dyspnoea; stroke Frequency not known QT interval prolongation; sepsis Side-effects, further information In those with type 1 hepatorenal syndrome, terlipressin acetate can cause serious or fatal respiratory failure, and can increase the risk of sepsis and septic shock.
Interactions
**Severe interactions:**
- Concomitant treatment with drugs known to induce bradycardia (e.g.
**Other interactions (1):**
- Therefore, extreme caution should be exercised in the use of terlipressin in patients with concomitant medications that can prolong the QT interval, such as class IA and III antiarrhythmics,...
Pregnancy
Avoid unless benefits outweigh risk-uterine contractions and increased intra-uterine pressure in early pregnancy, and decreased uterine blood flow reported.
Breast feeding
Avoid unless benefits outweigh risk-no information available.
Hepatic impairment
For Variquel injection When used for Type 1 hepatorenal syndrome: MHRA advises avoid in severe impairment-see Important safety information .
Renal impairment
Use with caution in chronic renal failure. M Renal impairment For Variquel injection When used for Type 1 hepatorenal syndrome: MHRA advises avoid in severe impairment-see Important safety information .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Terlipressin acetate in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary