Indications for: VASOSTRICT
To increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines.
Use lowest effective dose. Post-cardiotomy shock: initially 0.03U/min; max 0.1U/min. Septic shock: initially 0.01U/min; max 0.07U/min. May titrate up by 0.005U/min at 10–15min intervals until target BP is achieved. After target BP maintained for 8hrs without use of catecholamines, taper by 0.005U/min every hour as tolerated to maintain target BP.
Multi-dose vial: chlorobutanol allergy.
Decrease in cardiac index may be observed. Reversible diabetes insipidus. Monitor serum electrolytes, fluid status, and urine output after discontinuation. Elderly. Pregnancy (2nd & 3rd trimester: may need to increase dose). Nursing mothers.
Additive effect with concomitant catecholamines; monitor and adjust vasopressin dose as needed. May be potentiated by indomethacin, ganglionic blocking agents, SSRIs, tricyclics, haloperidol, chlorpropamide, enalapril, methyldopa, pentamidine, vincristine, cyclophosphamide, ifosfamide, felbamate; monitor and adjust vasopressin dose as needed. May be antagonized by demeclocycline, lithium, foscarnet, clozapine; monitor and adjust vasopressin dose as needed.
Decreased cardiac output, bradycardia, tachyarrhythmias, hyponatremia, ischemia (coronary, mesenteric, skin, digital).
Generic Drug Availability:
Single-dose vials (1mL)—10, 25; Multi-dose vial (10mL)—1; Premixed single-dose vials (100mL)—10