terlipressin
{{Short description|Chemical compound}}
{{cs1 config|name-list-style=vanc|display-authors=6}}
{{Infobox drug
| verifiedrevid = 470602469
| image = terlipressin.png
| alt =
| tradename = Terlivaz
| Drugs.com = {{drugs.com|international|terlipressin}}
| pregnancy_category =
| routes_of_administration = Intravenous
| ATC_prefix = H01
| ATC_suffix = BA04
| ATC_supplemental =
| legal_AU =
| legal_AU_comment =
| legal_BR =
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| legal_CA =
| legal_CA_comment =
| legal_DE =
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| legal_NZ =
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| legal_UK =
| legal_UK_comment =
| legal_US = Rx-only
| legal_US_comment = {{cite web | title=Drug Approval Package: Terlivaz | publisher=U.S. Food and Drug Administration (FDA) | date=7 October 2022 | url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2022/022231Orig1s000TOC.cfm | access-date=4 December 2022}}
| legal_EU =
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| bioavailability =
| protein_bound = ~30%
| metabolism =
| elimination_half-life =
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 14636-12-5
| PubChem = 72081
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB02638
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 65067
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 7Z5X49W53P
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D06672
| IUPAC_name = 1-
| C=52 | H=74 | N=16 | O=15 | S=2
| smiles = O=C(N)CNC(=O)[C@@H](NC(=O)[C@H]4N(C(=O)[C@H]1NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)CNC(=O)CNC(=O)CN)CSSC1)Cc2ccc(O)cc2)Cc3ccccc3)CCC(=O)N)CC(=O)N)CCC4)CCCCN
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C52H74N16O15S2/c53-17-5-4-9-31(45(76)60-23-41(57)72)63-51(82)38-10-6-18-68(38)52(83)37-27-85-84-26-36(61-44(75)25-59-43(74)24-58-42(73)22-54)50(81)65-34(20-29-11-13-30(69)14-12-29)48(79)64-33(19-28-7-2-1-3-8-28)47(78)62-32(15-16-39(55)70)46(77)66-35(21-40(56)71)49(80)67-37/h1-3,7-8,11-14,31-38,69H,4-6,9-10,15-27,53-54H2,(H2,55,70)(H2,56,71)(H2,57,72)(H,58,73)(H,59,74)(H,60,76)(H,61,75)(H,62,78)(H,63,82)(H,64,79)(H,65,81)(H,66,77)(H,67,80)/t31-,32-,33-,34-,35-,36-,37-,38-/m0/s1
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = BENFXAYNYRLAIU-QSVFAHTRSA-N
}}
Terlipressin, sold under the brand name Terlivaz among others, is an analogue of vasopressin used as a vasoactive drug in the management of low blood pressure. It has been found to be effective when norepinephrine does not help. Terlipressin is a vasopressin receptor agonist.
Terlipressin was approved for medical use in the United States in 2022.{{cite web | title=Drug Approval Package: Terlivaz | website=U.S. Food and Drug Administration (FDA) | date=7 October 2022 | url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2022/022231Orig1s000TOC.cfm | access-date=23 January 2023}} The US Food and Drug Administration (FDA) considers it to be a first-in-class medication.{{cite web | title=Advancing Health Through Innovation: New Drug Therapy Approvals 2022 | website=U.S. Food and Drug Administration (FDA) | date=10 January 2023 | url=https://www.fda.gov/drugs/new-drugs-fda-cders-new-molecular-entities-and-new-therapeutic-biological-products/new-drug-therapy-approvals-2022 | access-date=22 January 2023}} {{PD-notice}}{{cite report | title=New Drug Therapy Approvals 2022 | website=U.S. Food and Drug Administration (FDA) | date=January 2024 | url=https://www.fda.gov/media/164429/download | format=PDF | access-date=14 January 2024 | archive-url=https://web.archive.org/web/20240114065648/https://www.fda.gov/media/164429/download | archive-date=14 January 2024 | url-status=live }} {{PD-notice}}
Medical uses
Terlipressin is indicated to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function.{{cite web | title=Terlivaz- terlipressin injection, powder, lyophilized, for solution | website=DailyMed | date=19 September 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3a35b86c-f451-4fac-8499-43019e4da354 | access-date=27 September 2022 | archive-date=28 September 2022 | archive-url=https://web.archive.org/web/20220928050107/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3a35b86c-f451-4fac-8499-43019e4da354 | url-status=live }}
Indications for use include norepinephrine-resistant septic shock{{cite journal | vauthors = O'Brien A, Clapp L, Singer M | title = Terlipressin for norepinephrine-resistant septic shock | journal = Lancet | volume = 359 | issue = 9313 | pages = 1209–1210 | date = April 2002 | pmid = 11955542 | doi = 10.1016/S0140-6736(02)08225-9 | s2cid = 38463837 }} although, 2021 Surviving Sepsis Guidelines recommend against its use for adults with septic shock{{cite journal | vauthors = Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C, Simpson S, Wiersinga WJ, Alshamsi F, Angus DC, Arabi Y, Azevedo L, Beale R, Beilman G, Belley-Cote E, Burry L, Cecconi M, Centofanti J, Coz Yataco A, De Waele J, Dellinger RP, Doi K, Du B, Estenssoro E, Ferrer R, Gomersall C, Hodgson C, Hylander Møller M, Iwashyna T, Jacob S, Kleinpell R, Klompas M, Koh Y, Kumar A, Kwizera A, Lobo S, Masur H, McGloughlin S, Mehta S, Mehta Y, Mer M, Nunnally M, Oczkowski S, Osborn T, Papathanassoglou E, Perner A, Puskarich M, Roberts J, Schweickert W, Seckel M, Sevransky J, Sprung CL, Welte T, Zimmerman J, Levy M | title = Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 | language = en-US | journal = Critical Care Medicine | volume = 49 | issue = 11 | pages = e1063–e1143 | date = November 2021 | pmid = 34605781 | doi = 10.1097/CCM.0000000000005337 | doi-access = free }} and hepatorenal syndrome.{{cite journal | vauthors = Uriz J, Ginès P, Cárdenas A, Sort P, Jiménez W, Salmerón JM, Bataller R, Mas A, Navasa M, Arroyo V, Rodés J | title = Terlipressin plus albumin infusion: an effective and safe therapy of hepatorenal syndrome | journal = Journal of Hepatology | volume = 33 | issue = 1 | pages = 43–48 | date = July 2000 | pmid = 10905585 | doi = 10.1016/S0168-8278(00)80158-0 }} In addition, it is used to treat bleeding esophageal varices.{{cite journal | vauthors = Ioannou G, Doust J, Rockey DC | title = Terlipressin for acute esophageal variceal hemorrhage | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD002147 | year = 2003 | pmid = 12535432 | pmc = 7017851 | doi = 10.1002/14651858.CD002147 | veditors = Ioannou GN }}
Contraindications
Society and culture
Terlipressin is available in United States,{{cite journal |title=FDA approves treatment to improve kidney function in adults with hepatorenal syndrome |journal=FDA |date=14 September 2022 |url=https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-improve-kidney-function-adults-hepatorenal-syndrome |url-status=live |archive-url=https://web.archive.org/web/20230210043353/https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-improve-kidney-function-adults-hepatorenal-syndrome |archive-date=2023-02-10 |access-date=2023-02-21}} New Zealand,{{cite web | title = GLYPRESSIN 1mg/8.5mL Solution for Injection; Terlipressin acetate | work = Medsafe, New Zealand Medicines and Medical Devices Safety Authority | publisher = New Zealand Ministry of Health | url = http://www.medsafe.govt.nz/profs/datasheet/g/Glypressin01mgmlFerringinj.pdf | archive-url = https://web.archive.org/web/20211220215013/https://www.medsafe.govt.nz/profs/Datasheet/g/Glypressin01mgmlFerringinj.pdf | archive-date=2021-12-20 }} Australia, the European Union,{{cite web|url=https://www.drugs.com/international/terlipressin.html|title=Terlipressin|access-date=2018-01-23|archive-date=2019-06-26|archive-url=https://web.archive.org/web/20190626082700/https://www.drugs.com/international/terlipressin.html|url-status=live | work = Drugs.com }} India, Indonesia, Pakistan, UAE. It is sold under various brand names including Glypressin and Terlivaz.
References
{{Reflist}}
External links
- {{cite web | url = https://druginfo.nlm.nih.gov/drugportal/name/terlipressin | publisher = U.S. National Library of Medicine | work = Drug Information Portal | title = Terlipressin }}
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