Terlipressin
Aliases: Terlipressin · Glypressin · Terlivaz
Last verified: 2026-09-23
The short version
A long-acting vasopressin analogue — hepatorenal syndrome (FDA 2022) and variceal bleeding.
Identity & type
- Molecular type
- analog
- Origin
- A long-acting vasopressin analogue — hepatorenal syndrome (FDA 2022) and variceal bleeding.
Mechanism of action
V1 agonism → splanchnic vasoconstriction → improved renal perfusion.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. IV boluses 0.85–1 mg every 4–6 h.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
IV boluses 0.85–1 mg every 4–6 h. A hospital drug for hepatorenal syndrome — restores kidney function in severe liver disease; no outpatient use.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
A hospital drug for hepatorenal syndrome — restores kidney function in severe liver disease; no outpatient use.
Protocol — official vs community
Official / label
Terlivaz (hepatorenal syndrome): 0.85–1 mg IV bolus every 4–6 h; once serum creatinine falls ≥20% from baseline, step down to 0.85 mg every 8 h, then every 12 h. European practice for acute variceal bleeding: 1–2 mg IV q4–6 h for 2–5 days, then wean.
- 01Initiate 0.85–1 mg IV q4–6h
- 02Creatinine ↓ ≥20% from baseline: step down to q8h, then q12h
- 03Creatinine ↑ ≥20% or intolerance: hold the drug
Duration: Days to ~2 weeks — defined by creatinine trajectory, not a fixed calendar.
A vasoconstrictor prodrug of lysine-vasopressin; ischemic complications (cardiac, mesenteric, digital) and respiratory failure are the constraints. In HRS it is given with albumin expansion as part of the protocol.
Community (anecdotal)
Structured protocol data for this entry is coming.
Human evidence
CONFIRM trial (HRS-AKI).
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Ischemic complications, respiratory failure (caution).characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials