For hepato-renal syndrome continue until serum creatinine is less than 130 micromol/L or has decreased by at least 30% since diagnosis. If serum creatinine does not decrease at least 25% after 3 days, the dose may be increased stepwise to a maximum of 2mg every 4 hours.
•Administer via peripheral or central line IV bolus
• Administer the required dose as an IV bolus over 1-2 minutes
Observation and Monitoring
• Blood pressure
• Fluid balance and accurate urine output. E.g catheterize if necessary
• Serum sodium and potassium
Mechanism of action
Terlipressin is a synthetic analogue of vasopressin. It is slowly converted in the body to lysine vasopressin. The slowly released vasopressin reduces blood flow in the splanchnic blood circulation, thereby helping to control bleeding from ruptured oesphageal varices. In hepato-renal syndrome, terlipressin causes vasoconstriction in splanchnic circulation, improving renal blood flow and GFR. It is used in combination with albumin infusions.