VASOPRESSIN

(Pressyn, Pitressin)

Standard Prescription

vasoppressin__units IV/SC Q__H

vasopressin__units/kg/min (or__units/kg/hr) continuous IV infusion


Dosages

Diabetes Insipidus:
IV/SC: 2.5-10 units/dose BID-QID.
Continuous IV Infusion: initial: 0.02 0.05 milliunits/kg/min = 0.00002 - 0.00005 units/kg/min. Titrate as needed to desired urine output to a maximum 0.2 milliunits/kg/min = 0.0002 units/kg/min. Maximum 0.2 milliunits/kg/min = 0.0002 units/kg/min

Diabetes Insipidus Urine Replacement Method:
Use 5 milliunits/mL (0.005 units/mL) concentration. Infuse as continuous IV infusion to replace urine output + 10% each hour.

Vasodilatory Shock:
Continuous IV infusion: 0.3 – 2 milliunits/kg/min = 0.0003 - 0.002 units/kg/min; titrate to effect Maximum 8 milliunits/kg/min 0.008 units/kg/min Usual adult maximum 0.04 units/min

Gastrointestinal Hemorrhage:
By continuous IV infusion 2-10 milliunits/kg/min = 0.002-0.01 units/kg/min; titrate as needed.

Maximum doses:
<5 yrs: 0.2 units/min
5-12 yrs: 0.3 units/min
>12 yrs: 0.4 units/min
Adults: 0.8 units/min

Mechanism of Action

Antidiuretic hormone analog; Vasopressin-1 and -2 receptor agonist
Role in homeostasis by regulation of water, glucose and salts.

Forms Supplied

injection: aqueous 20 units/1 mL, 100 units/5 mL

Comments

1 milliunit = 0.001 units; 1 unit = 1000 milliunits

Side effects occur more frequently at doses greater than 10 milliunits/kg/min = 0.01 units/kg/min.

Side effects include hypertension, electrolyte abnormalities, fluid overload, cardiac arhythmias, urticaria, anaphylaxis.

Monitor ins/outs, urine specific gravity, urine and serum osmolality and sodium.

Dosage can be highly variable – titrate based on serum and urine sodium, osmolality, fluid balance, and urine output.

Do not abruptly discontinue IV infusion (taper dose).

Some clinicians consider desmopressin the drug of choice for central diabetes insipidus.

References

12, 44, 179, 471

Last Edited

2019-09-01 11:17:35