Glipressina (Terlipressin)

Glipressina is indicated for the management of two serious conditions where rapid hemodynamic control is required.

• Hepatorenal syndrome type 1 in patients with advanced cirrhosis, to improve renal perfusion and function.
• Acute variceal bleeding associated with portal hypertension, to achieve hemostasis and reduce re‑bleeding risk.
• As a bridge therapy in liver transplantation candidates with refractory circulatory failure.
• In selected cases of septic shock unresponsive to conventional vasopressors, under specialist supervision.

Adverse reactions to Glipressina reflect its vasoconstrictive activity and may vary from mild to severe.

Common

• Headache
• Nausea or vomiting
• Abdominal pain or cramps
• Flushing or warmth at the infusion site

Serious

• Ischemic complications such as myocardial infarction or peripheral limb ischemia
• Severe hypertension or hypertensive crisis
• Cardiac arrhythmias, including tachycardia or bradycardia

Because Glipressina influences vascular tone and organ perfusion, several precautions should be observed before and during therapy.

• Assess cardiovascular status; avoid use in uncontrolled hypertension or recent myocardial infarction.
• Monitor renal function and electrolytes, especially in patients with pre‑existing kidney disease.
• Use cautiously in patients with coronary artery disease or peripheral vascular disease.
• Evaluate for signs of ischemia, particularly in the extremities and gastrointestinal tract.
• Adjust or discontinue therapy if severe hypertension or arrhythmias develop.
• Pregnancy and lactation status are unknown; avoid use unless benefits outweigh potential risks.

Glipressina may interact with other agents that affect vascular tone, cardiac function, or renal perfusion.

Avoid

• Concomitant use with other potent vasoconstrictors (e.g., norepinephrine, phenylephrine) due to additive hypertension risk.
• Combination with vasodilators such as nitroglycerin or hydralazine that may blunt therapeutic effect.

Use with caution

• Concurrent administration of beta‑blockers, which can mask tachycardia signs.
• Diuretics or nephrotoxic drugs, as renal perfusion changes may exacerbate kidney injury.
• Anticoagulants, because gastrointestinal ischemia can increase bleeding risk.