Glypressin (Terlipressin Acetate)

Glypressin is indicated for conditions where rapid reduction of portal venous pressure is required.

• Management of acute bleeding from esophageal varices in patients with portal hypertension.
• Treatment of hepatorenal syndrome type 1 to improve renal function in cirrhotic patients.
• Adjunctive therapy during liver transplantation to control intra‑operative bleeding.
• Supportive use in severe hypotension secondary to septic shock when conventional vasopressors are insufficient.

The safety profile of Glypressin reflects its vasoconstrictive activity, with side effects ranging from mild to potentially serious.

Common

• Headache, often mild and transient
• Nausea or vomiting, usually occurring during infusion
• Transient increase in blood pressure that resolves after discontinuation

Serious

• Severe hypertension or hypertensive crisis requiring immediate medical intervention
• Cardiac arrhythmias such as tachycardia or atrial fibrillation
• Peripheral ischemia with possible tissue necrosis, especially in extremities

Before initiating Glypressin, clinicians should evaluate several patient‑specific factors to minimize risk and ensure appropriate use.

• Known hypersensitivity to terlipressin or any component of the formulation.
• Pre‑existing cardiovascular disease, including uncontrolled hypertension or coronary artery disease.
• Severe hepatic impairment beyond the intended indication.
• Active gastrointestinal bleeding unrelated to esophageal varices.
• Pregnancy or breastfeeding status, as safety data are limited.
• Concomitant use of other potent vasoconstrictors.

Glypressin may interact with other agents that affect vascular tone or renal function, requiring careful medication review.

Avoid

• Other vasopressin analogs or high‑dose catecholamine vasopressors.
• Strong CYP3A4 inhibitors that could alter terlipressin metabolism.

Use with caution

• Diuretics, especially loop diuretics, due to potential additive effects on blood pressure.
• ACE inhibitors or ARBs, which may modify renal perfusion.
• Anticoagulants, as rapid hemostasis may mask bleeding signs.