Vasopressin Dosage

Medically reviewed by Drugs.com. Last updated on Sep 5, 2023.

Applies to the following strengths: 20 units/mL; 20 units/100 mL-NaCl 0.9%; 40 units/100 mL-NaCl 0.9%; 0.4 units/mL; 20 units/100 mL-D5%; 1 unit/mL-D5%; 1 unit/mL-NaCl 0.9%

Usual Adult Dose for:

Hypotension
Shock
Diabetes Insipidus
Abdominal Distension
Abdominal Radiological Procedure

Usual Adult Dose for Hypotension

Post-Cardiotomy Shock:

Initial dose: 0.03 units/min IV infusion
If target blood pressure response is not achieved: titrate up by 0.005 units/min at 10 to 15 minute intervals
Maximum rate of infusion: 0.1 units/min

Septic Shock:

Initial dose: 0.01 units/min IV infusion
If target blood pressure response is not achieved: titrate up by 0.005 units/min at 10 to 15 minute intervals
Maximum rate of infusion: 0.07 units/min

Comments:

After target blood pressure has been maintained for 8 hours without use of catecholamines, taper by 0.005 units/min every hour as tolerated to maintain target blood pressure.
The goal of treatment is optimization of perfusion to critical organs, however, aggressive treatment can compromise perfusion of organs; titrate to the lowest dose compatible with a clinically acceptable response.

Use: To increase blood pressure in patients with vasodilatory shock (e.g., post-cardiotomy or sepsis) who remain hypotensive despite fluids and catecholamines

Usual Adult Dose for Shock

Post-Cardiotomy Shock:

Initial dose: 0.03 units/min IV infusion
If target blood pressure response is not achieved: titrate up by 0.005 units/min at 10 to 15 minute intervals
Maximum rate of infusion: 0.1 units/min

Septic Shock:

Initial dose: 0.01 units/min IV infusion
If target blood pressure response is not achieved: titrate up by 0.005 units/min at 10 to 15 minute intervals
Maximum rate of infusion: 0.07 units/min

Comments:

After target blood pressure has been maintained for 8 hours without use of catecholamines, taper by 0.005 units/min every hour as tolerated to maintain target blood pressure.
The goal of treatment is optimization of perfusion to critical organs, however, aggressive treatment can compromise perfusion of organs; titrate to the lowest dose compatible with a clinically acceptable response.

Use: To increase blood pressure in patients with vasodilatory shock (e.g., post-cardiotomy or sepsis) who remain hypotensive despite fluids and catecholamines

Usual Adult Dose for Diabetes Insipidus

5 to 10 units (0.25 to 0.5 mL) IM or subcutaneously repeated 2 or 3 times a day as needed

Comments:

May be administered intranasally on cotton pledgets, by nasal spray, or by dropper as well; the dose and interval between treatments must be determined for each patient.
This drug has not been found by the by the US FDA to be safe and effective and the labeling has not been approved by the US FDA.

Usual Adult Dose for Abdominal Distension

5 units (0.25 mL) IM or subcutaneously initially; increase to 10 units (0.5 mL) at subsequent injections if necessary and repeated at 3 to 4 hour intervals as required

Comments:

This drug has not been found by the by the US FDA to be safe and effective and the labeling has not been approved by the US FDA.

Usual Adult Dose for Abdominal Radiological Procedure

2 injections of 10 units (0.5 mL) each IM or subcutaneously given 2 hours and one-half hour, respectively, before films are exposed

Comments:

This drug has not been found by the by the US FDA to be safe and effective and the labeling has not been approved by the US FDA.
Some roentgenologists advise giving an enema prior to the first injection.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

IM and subcutaneous: Doses should be appropriately reduced in children, however, no specific guidelines have been suggested.

IV: Dose selection in elderly patients should be done cautiously, starting at the lower end of the dosing range reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Precautions

CONTRAINDICATIONS (IV): Known allergy or hypersensitivity to 8-L-arginine vasopressin or chlorobutanol

CONTRAINDICATIONS (IM or Subcutaneous): Hypersensitivity or anaphylaxis to the active component or to any of the ingredients

IV: Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration Advice:
IM and Subcutaneous Formulations:

IM is the preferred route, however, may also be given subcutaneous.

IV:

Titrate to the lowest dose compatible with clinically acceptable response.
To be diluted prior to IV administration; consult the manufacturer product information.

Storage Requirements:
IV Vials:

Store between 2C and 8C; do not freeze.
Vials may be held up to 12 months upon removal from refrigeration to room temperature anytime within the labeled shelf life; once removed from refrigeration, unopened vials should be marked to indicated revised 12 month expiration date. If the manufacturer's original expiration date is shorter than the revised, then the shorter date must be used; do not use beyond manufacturer expiration date stamped on vial.
After initial entry into the 10 mL vial, the remaining contents must be refrigerated and discarded 30 days after first puncture.
Discard unused diluted solutions for IV administration after 18 hours at room temperature or 24 hours under refrigeration.

IM and Subcutaneous Vials:

Do not freeze.

Reconstitution/preparation techniques:

The manufacturer product information should be consulted.

General:

The lowest effective dose should be used.

Monitoring:

Cardiovascular: ECG and fluid and electrolyte status determinations are recommended at periodic intervals during therapy.

Patient advice:

Side effects including blanching of skin, abdominal cramps, and nausea may be reduced by taking 1 or 2 glasses of water at the time of drug administration.