Drug reference

Vasopressin

Antidiuretic / vasopressor peptide hormone (ADH analogue) · Vasopressor; Antidiuretic

Also known as Arginine vasopressin, AVP, Antidiuretic hormone, Pitressin

START

Septic shock: 0.03 units/min IV (fixed, not titrated up)

TYPICAL MAX

0.04 units/min (shock); higher only for varices

STOP IF

Digital/mesenteric/cardiac ischaemia or severe hypertension

WATCH

MAP, perfusion, sodium, ECG, infusion-site integrity

CDSCO approvedSchedule HATC H01BA01

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 3min · pressor onset
PEAK: 15min · steady state
t½: 15min · t½ ~15 min
DURATION: 45min · post-stop

EXCRETION

Hepatic/renal peptidases; renal metabolites

route + CYP

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Use only if clearly needed; may cause uterine contractions.

FDA category + note

Top interactionssee all 12 →

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Available in India

8 branded formulations. Look up specific brands in the Drugs workspace.

Mechanism

Agonist at V1 vascular receptors (vasoconstriction via phospholipase C) and V2 renal collecting-duct receptors (aquaporin-2 insertion → water reabsorption); restores vascular tone in vasodilatory shock and reduces splanchnic flow in variceal bleeding.

Indications

Vasodilatory/septic shock (catecholamine-refractory)Cardiac arrest (adjunct, selected)Central diabetes insipidusBleeding oesophageal varicesPost-cardiotomy vasoplegia

Dosing

Adult: Septic shock: 0.01–0.04 units/min IV infusion (fixed, not titrated to high doses). Variceal bleed: 0.2–0.4 units/min IV. Central DI: 5–10 units SC/IM 2–4 times daily.
Pediatric: Shock: 0.0003–0.002 units/kg/min (specialist/PICU).
Renal adjustment: No specific adjustment in shock dosing; monitor fluid/sodium.
Hepatic adjustment: No specific adjustment; titrate to effect.
Geriatric: Caution — vascular/ischaemic risk.
Max dose: 0.04 units/min (septic shock infusion ceiling)

Pharmacokinetics

Onset

Rapid (minutes) — pressor effect

Peak effect

~15 min (infusion steady state)

Duration

30–60 min after stopping infusion

Half-life

10–20 min

Bioavailability

IV 100% (peptide; not oral)

Protein binding

Minimal

Metabolism

Hepatic/renal peptidases (vasopressinases)

Excretion

Renal (metabolites); small amount unchanged

Contraindications

Hypersensitivity
Chronic nephritis with nitrogen retention (until reasonable BUN)
Caution in coronary/vascular disease

Side effects

Common

PallorAbdominal crampsTremorHeadacheBradycardia

Serious

Myocardial/mesenteric/digital ischaemia
Severe hypertension
Hyponatraemia/water intoxication
Skin necrosis on extravasation

Pregnancy & lactation

Pregnancy

Use only if clearly needed; may cause uterine contractions.

Lactation

Limited data; short-term critical-care use generally acceptable.