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Angiotensin ii parenteral


Infusions of angiotensin II.

Drugs List

  • angiotensin II 2.5mg/1ml solution for infusion vial
  • GIAPREZA 2.5mg/1ml concentrate for solution for infusion vial
  • Therapeutic Indications


    Catecholamine-refractory hypotension after distributive shock

    Persistent refractory hypotension in adults with septic or other distributive shock despite adequate volume restitution and application of catecholamines and other vasopressor therapies.



    20nanograms/kg/minute. Down-titration may be required in patients who experience transient hypertension at this dose.

    Dose may be titrated every 5 minutes in steps of up to 15nanograms/kg/minute depending on the patients response. The dose must be less than or equal to 80nanograms/kg/minute during the first 3 hours of treatment.

    Dose may be maintained as low as 1.25nanograms/kg/minute. Maximum maintenance dose is 40nanograms/kg/minute.

    Additional Dosage Information

    Discontinuing treatment
    Angiotensin II should be withdrawn once the underlying shock has sufficiently improved. To avoid hypotension due to abrupt withdrawal, angiotensin II should be down-titrated by gradual decrements of up to 15nanograms/kg/minute.


    Intravenous infusion only via a central venous line, following dilution.


    Children under 18 years

    Precautions and Warnings


    Treatment to be prescribed under the supervision of a specialist
    Monitor blood pressure continuously
    Must be diluted before use
    Monitor haemodynamics of circulation
    Increased risk for venous thromboembolism - take preventive measures
    Avoid abrupt withdrawal
    Hospital use only
    Maintain treatment at the lowest effective dose

    Angiotensin II is not recommended for use in patients with non-distributive shock.

    Concurrent venous thromboembolism prophylaxis should be considered during treatment.

    Patients may be more sensitive to the action of angiotensin II and therefore have an increased response if they have recently received angiotensin converting enzyme inhibitors. On the other hand, patients may be less sensitive to the action of angiotensin II, and therefore have a reduced response if they have recently received angiotensin II receptor blockers.

    Pregnancy and Lactation


    Use angiotensin II with caution during pregnancy.

    The manufacturer does not recommend using angiotensin II during pregnancy unless the benefit to the patient outweighs the possible risk to the foetus. At the time of writing there is limited published information regarding the use of angiotensin II during pregnancy. Potential risks are unknown.


    Angiotensin II is contraindicated during breastfeeding.

    Use of angiotensin II when breastfeeding is contraindicated by the manufacturer. The presence of angiotensin II in human breast milk in unknown. Effects on exposed infants are unknown.

    Side Effects

    Deep vein thrombosis (DVT)
    Hypertension (transient)
    Peripheral ischaemia


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: November 2022

    Reference Sources

    Summary of Product Characteristics: Giapreza 2.5mg per ml concentrate for solution for infusion. PAION UK Ltd. Revised October 2021.

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.