- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Solution for injection containing 0.4mg/ml of argipressin (arginine vasopressin) which is equivalent to 20 international units per ml.
Neurohypophyseal diabetes insipidus - short term therapy for prevention and control of polydipsia, polyuria and dehydration in patients with diabetes insipidus caused by a deficiency of endogenous posterior pituitary antidiuretic hormone.
Control of bleeding from oesophageal varices.
Adjunct in acute massive haemorrhage of gastrointestinal tract or oesophageal varices in children.
Dosage should be individually determined as required.
Dosing should be carried out under specialist management only.
0.25ml to 1ml (5 units to 20 units) subcutaneously or intramuscularly every 4 hours.
Initial control: 1ml (20 units) diluted with 100ml glucose injection 5% w/v and infused intravenously over a period of 15 minutes.
No clinical or pharmacokinetic data specific to this age group are available. However the drug has been used successfully at normal adult dosage in the elderly.
(See Dosage; Adults)
Not licensed in children under 18 years.
Adjunct in oesophageal varices or acute massive haemorrhage of gastrointestinal tract (unlicensed)
Initial dose: 0.3 units/kg over 20 to 30 minutes (up to a maximum of 20 units). To be given by intravenous infusion.
Maintenance dose: 0.3 units/kg/hour, titrated to response (up to a maximum of 1 unit/kg/hour). To be given by slow intravenous infusion or infused directly into the superior mesenteric artery.
If bleeding stops, continue at the same dose for a further 12 hours, then withdraw gradually over a period of 24 to 48 hours.
Maximum duration of treatment: 72 hours.
Dilute before use to a concentration of 0.2 to 1 unit per ml using glucose 5% injection or sodium chloride 0.9% injection.
Patients with Renal Impairment
Contraindicated in chronic nephritis until nitrogen blood levels normalised.
Argipressin may be given by subcutaneous, intramuscular or intravenous injection.
For intravenous administration in the control of oesophageal varices, further dilution into a larger volume is required.
Glucose injection 5%
Sodium chloride injection 0.9%
Chronic nephritis with nitrogen retention (until nitrogen blood levels normalised)
Precautions and Warnings
Use with extreme caution in patients with vascular disease (especially disease of the coronary arteries) and systemic hypertension. With large doses myocardial infarction may occur and even small doses may precipitate pain.
If used in patients with peripheral vascular disease, the skin should be observed carefully for signs of ischaemia.
Use with caution in the following conditions as rapid addition of extracellular water may be hazardous:
Pregnancy (see Pregnancy section)
Fluid intake should be adjusted to avoid hyponatraemia and water intoxication.
Monitor for early signs of water intoxication, such as drowsiness, listlessness and headaches, to prevent terminal coma and convulsions
May cause vertigo. Advise patients not to drive or operate machinery if affected
Pregnancy and Lactation
Argipressin has been used successfully for the treatment of diabetes insipidus during pregnancy and no adverse effects on the foetus has been reported.
Briggs (2011) states that a three fold increase of circulating levels of endogenous vasopressin has been reported for women in the last trimester and in labour compared with nonpregnant women. The induction of uterine activity (oxytocic effect) has been reported after of administration intramuscular and intranasal vasopressin.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Argipressin has been administered to breast feeding women without apparent adverse effects on the infant.
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
Effects on Ability to Drive and Operate Machinery
No specific tests on the ability to drive or operate machinery have been conducted. However side effects such as vertigo have been reported and may affect the ability to perform skilled tasks such as driving or operation of machinery.
Advise patients of the possible effects of vertigo which may affect their ability to drive or operate machinery.
Desire to defaecate
Constriction of coronary arteries
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 ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Shelf Life and Storage
Store at 2-8 degrees C.
Do not freeze.
Last Full Review Date: June 2012
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.
Summary of Product Characteristics: Argipressin 20 IU/ml Solution for Injection. Mercury Pharma Group. Revised May 2012.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 17 August 2017
Already a member? Log in
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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.