Vasopressin

Clinical IV dosing: Septic shock: 0.01-0.07 units/min continuous infusion (start 0.01, titrate by 0.005 every 10-15 min). Post-cardiotomy shock: 0.03-0.1 units/min. Diabetes insipidus: 0.0005 units/kg/hr IV, doubling every 30 min (max 0.01 units/kg/hr). Available as 20 units/mL injection. Taper by 0.005 units/min every hour after 8 hours of stable blood pressure.

Binds V2 receptors on principal cells of the collecting duct, triggering a cAMP cascade that phosphorylates and inserts aquaporin-2 water channels into the apical membrane, increasing water reabsorption and concentrating urine.

Binds V1A receptors on vascular smooth muscle, activating phospholipase C and increasing intracellular calcium, causing vasoconstriction and raising blood pressure.

Binds V1B receptors in the anterior pituitary, stimulating ACTH release and modulating the hypothalamic-pituitary-adrenal axis stress response.

FDA-approved for increasing blood pressure in adults with vasodilatory shock (including septic shock) refractory to catecholamines and fluids.

Treats central diabetes insipidus by replacing deficient ADH, controlling polyuria and restoring water balance.

Used to support blood pressure in post-cardiotomy shock when other vasopressors are insufficient.

Historically used to reduce portal venous pressure and control variceal hemorrhage through splanchnic vasoconstriction.

Study 41757229

Study 41756405

Study 41751456