Terlipressin Explained

Verifiedrevid:470602469
Tradename:Terlivaz
Routes Of Administration:Intravenous
Atc Prefix:H01
Atc Suffix:BA04
Legal Us:Rx-only
Legal Us Comment:[1]
Protein Bound:~30%
Cas Number:14636-12-5
Pubchem:72081
Drugbank:DB02638
Chemspiderid:65067
Unii:7Z5X49W53P
Kegg:D06672
Iupac Name:1--L-prolyl-N-(2-amino-2-oxoethyl)-L-lysinamide
C:52
H:74
N:16
O:15
S:2
Smiles:O=C(N)CNC(=O)[C@@H](NC(=O)[C@H]4N(C(=O)[C@H]1NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)CNC(=O)CNC(=O)CN)CSSC1)Cc2ccc(O)cc2)Cc3ccccc3)CCC(=O)N)CC(=O)N)CCC4)CCCCN
Stdinchi:1S/C52H74N16O15S2/c53-17-5-4-9-31(45(76)60-23-41(57)72)63-51(82)38-10-6-18-68(38)52(83)37-27-85-84-26-36(61-44(75)25-59-43(74)24-58-42(73)22-54)50(81)65-34(20-29-11-13-30(69)14-12-29)48(79)64-33(19-28-7-2-1-3-8-28)47(78)62-32(15-16-39(55)70)46(77)66-35(21-40(56)71)49(80)67-37/h1-3,7-8,11-14,31-38,69H,4-6,9-10,15-27,53-54H2,(H2,55,70)(H2,56,71)(H2,57,72)(H,58,73)(H,59,74)(H,60,76)(H,61,75)(H,62,78)(H,63,82)(H,64,79)(H,65,81)(H,66,77)(H,67,80)/t31-,32-,33-,34-,35-,36-,37-,38-/m0/s1
Stdinchikey:BENFXAYNYRLAIU-QSVFAHTRSA-N

Terlipressin, sold under the brand name Terlivaz among others, is an analogue of vasopressin used as a vasoactive drug in the management of low blood pressure. It has been found to be effective when norepinephrine does not help. Terlipressin is a vasopressin receptor agonist.

Terlipressin was approved for medical use in the United States in 2022.[2] The US Food and Drug Administration (FDA) considers it to be a first-in-class medication.[3] [4]

Medical uses

Terlipressin is indicated to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function.[5]

Indications for use include norepinephrine-resistant septic shock[6] although, 2021 Surviving Sepsis Guidelines recommend against its use for adults with septic shock[7] and hepatorenal syndrome.[8] In addition, it is used to treat bleeding esophageal varices.[9]

Contraindications

Terlipressin is contraindicated in people experiencing hypoxia or worsening respiratory symptoms and in people with ongoing coronary, peripheral or mesenteric ischemia. Terlipressin may cause fetal harm when used during pregnancy.

Society and culture

Terlipressin is available in United States,[10] New Zealand,[11] Australia, the European Union,[12] India, Pakistan & UAE. It is sold under various brand names including Glypressin and Terlivaz.

External links

Notes and References

  1. Web site: Drug Approval Package: Terlivaz . U.S. Food and Drug Administration (FDA) . 7 October 2022 . 4 December 2022.
  2. Web site: Drug Approval Package: Terlivaz . U.S. Food and Drug Administration (FDA) . 7 October 2022 . 23 January 2023.
  3. Web site: Advancing Health Through Innovation: New Drug Therapy Approvals 2022 . U.S. Food and Drug Administration (FDA) . 10 January 2023 . 22 January 2023.
  4. New Drug Therapy Approvals 2022 . U.S. Food and Drug Administration (FDA) . January 2024 . PDF . 14 January 2024 . https://web.archive.org/web/20240114065648/https://www.fda.gov/media/164429/download . 14 January 2024 . live .
  5. Web site: Terlivaz- terlipressin injection, powder, lyophilized, for solution . DailyMed . 19 September 2022 . 27 September 2022 . 28 September 2022 . https://web.archive.org/web/20220928050107/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3a35b86c-f451-4fac-8499-43019e4da354 . live .
  6. O'Brien A, Clapp L, Singer M . Terlipressin for norepinephrine-resistant septic shock . Lancet . 359 . 9313 . 1209–1210 . April 2002 . 11955542 . 10.1016/S0140-6736(02)08225-9 . 38463837 .
  7. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C, Simpson S, Wiersinga WJ, Alshamsi F, Angus DC, Arabi Y, Azevedo L, Beale R, Beilman G, Belley-Cote E, Burry L, Cecconi M, Centofanti J, Coz Yataco A, De Waele J, Dellinger RP, Doi K, Du B, Estenssoro E, Ferrer R, Gomersall C, Hodgson C, Hylander Møller M, Iwashyna T, Jacob S, Kleinpell R, Klompas M, Koh Y, Kumar A, Kwizera A, Lobo S, Masur H, McGloughlin S, Mehta S, Mehta Y, Mer M, Nunnally M, Oczkowski S, Osborn T, Papathanassoglou E, Perner A, Puskarich M, Roberts J, Schweickert W, Seckel M, Sevransky J, Sprung CL, Welte T, Zimmerman J, Levy M . Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 . en-US . Critical Care Medicine . 49 . 11 . e1063–e1143 . November 2021 . 34605781 . 10.1097/CCM.0000000000005337 . free .
  8. Uriz J, Ginès P, Cárdenas A, Sort P, Jiménez W, Salmerón JM, Bataller R, Mas A, Navasa M, Arroyo V, Rodés J . Terlipressin plus albumin infusion: an effective and safe therapy of hepatorenal syndrome . Journal of Hepatology . 33 . 1 . 43–48 . July 2000 . 10905585 . 10.1016/S0168-8278(00)80158-0 .
  9. Ioannou G, Doust J, Rockey DC . Terlipressin for acute esophageal variceal hemorrhage . The Cochrane Database of Systematic Reviews . 1 . CD002147 . 2003 . 12535432 . 7017851 . 10.1002/14651858.CD002147 . Ioannou GN .
  10. FDA approves treatment to improve kidney function in adults with hepatorenal syndrome . FDA . 14 September 2022 . live . https://web.archive.org/web/20230210043353/https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-improve-kidney-function-adults-hepatorenal-syndrome . 2023-02-10 . 2023-02-21.
  11. Web site: GLYPRESSIN 1mg/8.5mL Solution for Injection; Terlipressin acetate . Medsafe, New Zealand Medicines and Medical Devices Safety Authority . New Zeeland Ministry of Health . https://web.archive.org/web/20211220215013/https://www.medsafe.govt.nz/profs/Datasheet/g/Glypressin01mgmlFerringinj.pdf . 2021-12-20 .
  12. Web site: Terlipressin. 2018-01-23. 2019-06-26. https://web.archive.org/web/20190626082700/https://www.drugs.com/international/terlipressin.html. live . Drugs.com .

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