More from Varipress
Other strengths and forms by Beacon Pharmaceuticals PLC
Indications & Uses
Terlipressin Acetate is used for the short term management of bleeding oesophageal varices. It is also used as emergency treatment of type 1 hepatorenal syndrome, as defined by the IAC (International Ascites Club) criteria.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
For short term management of bleeding oesophageal varices, Terlipressin Acetate is given as an i.v. injection of 2 mg (2x8.5 ml) every 4 hours at the start. Treatment continues until the bleeding has been controlled for 24 hours, but for no more than 48 hours. After the first dose, the dose can be lowered to 1 mg (8.5 ml) i.v. every 4 hours in patients with a body weight below 50 kg, or if adverse effects occur.
In type 1 hepatorenal syndrome, the i.v. injection is 3 to 4 mg (3x8.5 ml to 4x8.5 ml) of Terlipressin Acetate every 24 hours, given as 3 or 4 administrations. If the serum creatinine has not fallen at all after 3 days of treatment, stopping Terlipressin Acetate is advised. In other cases, treatment is continued until the serum creatinine is less than 130 µmol/litre, or until it has dropped by at least 30% from the value measured when the hepatorenal syndrome was diagnosed. The standard average duration of treatment is 10 days.
Side Effects
In clinical trials, the side effects most often reported with Terlipressin Acetate were paleness, raised blood pressure, abdominal pain, nausea, diarrhoea and headache.
Cautions & Contraindications
Warnings & Precautions
Cardiac, pulmonary and vascular disease: during treatment with terlipressin, blood pressure, ECG, heart rate, serum sodium and potassium levels and fluid balance all need regular monitoring and control. Take care when treating patients with hypertension, recognised heart disease, renal dysfunction, cerebral or peripheral vascular disease, asthma or respiratory failure. Septic shock: don't use terlipressin in patients with septic shock who have a low cardiac output. Injection site reaction: the injection must be given intravenously, so that local necrosis at the injection site is avoided. Torsade de pointes: clinical trials and post-marketing experience have reported several cases of QT interval prolongation and ventricular arrhythmias, including "Torsade de pointes". Most of these patients already had predisposing factors, such as basal prolongation of the QT interval, electrolyte abnormalities (hypokalemia, hypomagnesemia) or medicines that also affect QT prolongation. So extreme caution is needed when terlipressin is used in patients with a history of QT interval prolongation, electrolyte abnormalities, or concomitant medicines that can prolong the QT interval. A prior check is needed before terlipressin is used for hepatorenal syndrome. It must be established that the patient has an acute functional renal failure, and that this functional renal failure does not respond to a suitable plasma expansion therapy. Paediatric population and elderly patients: take particular care when treating children and elderly patients, because experience in these groups is limited. There is no data available on dosage recommendations for these special patient categories. Excipients: each ampoule of this medicinal product contains 1.33 mmol (30.7 mg) of sodium, which is equivalent to 1.5% of the WHO recommended maximum daily intake of 2 g sodium for an adult.
Contraindications
Don't give Terlipressin Acetate to anyone who is hypersensitive to the active substance or to any of the excipients in the preparation. It must also not be used in pregnancy.
Pregnancy & Breastfeeding
Terlipressin Acetate must not be used during pregnancy. It has been shown to cause uterine contractions and raise the pressure inside the uterus in early pregnancy, and it may reduce the blood flow to the uterus. It may harm the pregnancy and the foetus. In rabbits, treatment with Terlipressin Acetate led to spontaneous abortion and malformation of the foetus.
Nobody knows yet whether Terlipressin Acetate passes into human breast milk. Its excretion in milk hasn't been studied in animals either, so a risk to the breastfed child can't be ruled out. The decision to continue or stop breastfeeding, or to continue or stop Terlipressin Acetate therapy, should be made by weighing the benefit of breastfeeding to the child against the benefit of the treatment to the mother.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Elderly patients: no data are available on a recommended dose of Terlipressin Acetate for elderly patients.
Paediatric population: no data are available on a recommended dose for children either.
Overdose
Don't go above the recommended dose for the patient group being treated with Terlipressin Acetate, because the risk of severe circulatory side effects rises with the dose. If a patient with known hypertension develops raised blood pressure, it can be controlled with 150 mcg clonidine i.v. Bradycardia that needs treatment should be treated with atropine.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Terlipressin Acetate in a refrigerator at 2-8°C. Keep the vial in its outer carton so it stays protected from light.
Drug Interactions
Common questions about Varipress 1 mg
What is Varipress 1 mg Injection?
Varipress 1 mg Injection is a medicine that contains Terlipressin Acetate. It is made by Beacon Pharmaceuticals PLC. It belongs to the Other preparations group of medicines.
What is Varipress used for?
Terlipressin Acetate is used for the short term management of bleeding oesophageal varices. It is also used as emergency treatment of type 1 hepatorenal syndrome, as defined by the IAC (International Ascites Club) criteria.
What are the side effects of Varipress?
In clinical trials, the side effects most often reported with Terlipressin Acetate were paleness, raised blood pressure, abdominal pain, nausea, diarrhoea and headache.
Can I take Varipress during pregnancy or while breastfeeding?
Terlipressin Acetate must not be used during pregnancy. It has been shown to cause uterine contractions and raise the pressure inside the uterus in early pregnancy, and it may reduce the blood flow to the uterus. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Varipress?
Don't go above the recommended dose for the patient group being treated with Terlipressin Acetate, because the risk of severe circulatory side effects rises with the dose. If a patient with known hypertension develops raised blood pressure, it can be controlled with 150 mcg clonidine i.v. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Varipress?
Store Terlipressin Acetate in a refrigerator at 2-8°C. Keep the vial in its outer carton so it stays protected from light.
Can I take other medicines with Varipress?
Some medicines can interact with Terlipressin Acetate, for example: Erythromycin, Propofol. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Varipress?
Varipress is a prescription (Rx) medicine. Take it as your doctor advises.