Indications for VASOSTRICT:
To increase blood pressure in vasodilatory shock (eg, post-cardiotomy or sepsis) 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 if target BP not 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.
Impaired cardiac response may worsen cardiac output. Reversible diabetes insipidus. Monitor serum electrolytes, fluid status, and urine output after discontinuation. Elderly. Pregnancy (Cat.C). Nursing mothers: advise to pump and discard breast milk for 1.5hrs after vasopressin dose.
Additive effect with concomitant catecholamines. May be potentiated by indomethacin, ganglionic blocking agents, furosemide, SSRIs, tricyclics, haloperidol, chlorpropamide, enalapril, methyldopa, pentamidine, vincristine, cyclophosphamide, ifosfamide, felbamate. May be antagonized by demeclocycline, lithium, foscarnet, clozapine.
Decreased cardiac output, bradycardia, tachyarrhythmias, hyponatremia, ischemia (coronary, mesenteric, skin, digital).
Generic Drug Availability:
Single-dose vials (1mL)—25; Multi-dose vial (10mL)—1