Glypressin (Terlipressin)

Glypressin is indicated for several serious hepatic and circulatory disorders where rapid reduction of portal pressure or improvement of renal perfusion is required.

• Management of acute variceal bleeding in patients with portal hypertension.
• Treatment of hepatorenal syndrome to improve kidney function in advanced liver disease.
• Adjunctive therapy for septic shock when conventional vasopressors are insufficient (off‑label use).
• Prevention of re‑bleeding after endoscopic control of esophageal varices.
• Supportive measure in selected cases of refractory hypotension related to liver failure.

The safety profile of Glypressin reflects its vasoconstrictive activity; side effects are reported across a range of frequencies.

Common

• Transient headache or dizziness.
• Nausea, abdominal discomfort, or mild vomiting.
• Peripheral vasoconstriction causing cold extremities.
• Hypertension that resolves after infusion.

Serious

• Severe hypertension or hypertensive crisis.
• Cardiac arrhythmias, including tachycardia.
• Ischemic complications such as myocardial ischemia or peripheral gangrene.
• Acute renal failure or worsening renal function.

Because Glypressin produces potent vasoconstriction, careful patient selection and monitoring are essential before and during therapy.

• Avoid use in patients with known hypersensitivity to terlipressin or vasopressin analogs.
• Use cautiously in individuals with cardiovascular disease, including coronary artery disease or uncontrolled hypertension.
• Monitor renal function closely, especially in patients with pre‑existing kidney impairment.
• Assess for signs of ischemia in the extremities, gastrointestinal tract, or myocardium during infusion.
• Adjust dose or discontinue if severe hypertension or arrhythmias develop.
• Use only under continuous hemodynamic monitoring in an intensive care setting.

Glypressin may interact with other agents that affect vascular tone, cardiac rhythm, or renal function, requiring dose adjustments or heightened observation.

Avoid

• Concurrent use with other potent vasoconstrictors (e.g., norepinephrine, phenylephrine) that may exacerbate hypertension.
• Combination with drugs that prolong the QT interval, increasing arrhythmia risk.
• Co‑administration with nephrotoxic agents in patients with compromised kidney function.

Use with caution

• Concurrent diuretics, which may amplify changes in blood pressure and electrolyte balance.
• Beta‑blockers, as they can mask tachycardia while hypertension persists.
• Anticoagulants, because rapid hemodynamic shifts may affect bleeding risk.