ICU Drugs · V1/V2 receptor agonist
Vasopressin
Dose
0.01–0.04 U/min IV infusion (fixed-rate, NOT titrated above 0.04)
Mechanism
Non-adrenergic vasoconstriction via V1 receptors on vascular smooth muscle
Indications
- • Septic shock refractory to noradrenaline
- • Vasoplegic shock post-cardiac surgery
Contraindications
- • Coronary artery disease (relative)
Dilution & preparation
20 U in 100 mL D5W = 0.2 U/mL via central line
Use
Adjunct to noradrenaline in septic shock to spare catecholamine dose.
Monitoring
MAP, urine output, peripheral perfusion, ischaemia (digit, mesenteric, coronary).
Side effects
- • Peripheral / mesenteric / coronary ischaemia
- • Hyponatraemia (V2)
- • Cardiac arrest if bolused
Pregnancy safety
Use if benefit > risk
Related in WardRound
Always confirm dose against your local formulary / BNF before prescribing.
