Glypressin (Terlipressin Acetate)

Glypressin is indicated for the management of acute bleeding related to portal hypertension.

• Control of active esophageal variceal hemorrhage in patients with cirrhosis.
• Reduction of portal venous pressure during endoscopic or pharmacologic therapy.
• Adjunctive treatment for bleeding gastric varices when conventional measures are insufficient.
• Temporary stabilization of hemodynamics in patients awaiting definitive portal decompression procedures.
• Management of bleeding from ectopic varices associated with portal hypertension.
• Supportive therapy in patients with hepatorenal syndrome secondary to severe portal hypertension.

The pharmacologic activity of Glypressin can produce a range of adverse effects, which are typically categorized by frequency and severity.

Common

• Headache or facial flushing.
• Nausea, vomiting, or abdominal discomfort.
• Transient hypertension or increase in blood pressure.
• Peripheral edema or swelling of the extremities.

Serious

• Myocardial ischemia or chest pain.
• Severe hypertension leading to hypertensive crisis.
• Cardiac arrhythmias, including tachycardia.
• Ischemic limb events or digital necrosis.

Before initiating Glypressin therapy, clinicians should evaluate several patient‑specific factors to minimize risk.

• Known hypersensitivity to terlipressin acetate or any component of the formulation.
• Pre‑existing cardiovascular disease, such as coronary artery disease or uncontrolled hypertension.
• Severe hepatic impairment or advanced cirrhosis with portal hypertension.
• Renal dysfunction, especially in patients with hepatorenal syndrome.
• Pregnancy and lactation status, as safety data are limited.
• Concomitant use of other vasoconstrictive agents that may amplify blood pressure effects.

Glypressin may interact with other medications, altering its vasoconstrictive effect or increasing adverse event risk.

Avoid

• Other vasopressin analogs or potent vasoconstrictors (e.g., norepinephrine, phenylephrine).
• Monoamine oxidase inhibitors (MAOIs) that can potentiate hypertensive responses.

Use with caution

• Beta‑blockers, which may mask tachycardia.
• Diuretics, due to potential electrolyte disturbances.
• Anticoagulants, as changes in portal pressure could affect bleeding risk.
• Drugs affecting hepatic metabolism, such as certain antifungals or macrolide antibiotics.