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Terlipressin
📖 About
- Always check the BNF link here for the most up-to-date prescribing advice.
- Terlipressin is a synthetic analogue of vasopressin used in emergency management of variceal haemorrhage and hepatorenal syndrome (HRS).
⚙️ Mode of Action
- 🔒 V1 receptor agonist → potent vasoconstrictor.
- ⬇️ Increases systemic vascular resistance, especially in the splanchnic circulation, reducing portal venous pressure.
- 🩸 Leads to haemostasis in variceal bleeding.
- 💧 Has antihaemorrhagic and mild antidiuretic effects.
💊 Indications / Dose
- Acute oesophageal variceal bleed 🩸: 1–2 mg IV bolus, then 1 mg IV every 4–6 hours for up to 72 hours (or until bleeding controlled).
- Type 1 Hepatorenal Syndrome (HRS) 🧫: Improves renal perfusion and function, often combined with IV albumin. Acts as a bridge to liver transplantation and may improve survival.
🔗 Interactions
- 📖 See BNF for full list.
- ⚠️ Use with caution with drugs prolonging QT interval or those affecting cardiac rhythm.
⚠️ Cautions
- 💓 Arrhythmias, ischaemic heart disease, or history of MI.
- ⚡ Can cause abdominal cramps, diarrhoea, headache.
- 📉 Monitor electrolytes (risk of hyponatraemia) and ECG (QTc prolongation).
⛔ Contraindications
- 🚫 See BNF for details.
- Severe IHD, uncontrolled hypertension, or severe arrhythmias.
😬 Side Effects
- 💢 Abdominal cramps, nausea, vomiting, diarrhoea.
- 🤕 Headache, dizziness.
- ⬇️ Hyponatraemia, hypotension.
- ⚠️ Uterine and bowel contractions (avoid in pregnancy).
- 💓 May precipitate angina or MI → if chest pain, treat with GTN.
📚 References
- BNF: Terlipressin
- NICE & EASL guidelines on variceal haemorrhage and HRS management.
📝 Revisions
- Updated September 2025
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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