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Vasopressin

Septic shock (adjunct to norepinephrine), Cardiac arrest (alternative to epinephrine), Variceal hemorrhage

Indications

  • Septic shock (adjunct to norepinephrine)
  • Cardiac arrest (alternative to epinephrine)
  • Variceal hemorrhage

Adult dosing

  • septic shock: dose: 0.03; unit: units/min; route: IV; fixed: true; titrationTarget: Fixed at 0.03–0.04 units/min — do not titrate beyond 0.04; cardiac arrest: dose: 40; unit: units; route: IV; fixed: true; variceal: dose: 0.2; maxDose: 0.4; unit: units/min; route: IV; fixed: true

Pediatric dosing

  • shock: dose: 0.0003; maxDose: 0.002; unit: units/kg/min; route: IV; weightBased: true; titrationTarget: Max 0.04 units/min total

Clinical pearls

  • Fixed dose 0.03 units/min in septic shock — do NOT titrate
  • Add when norepinephrine requirements exceed 0.25 mcg/kg/min
  • In cardiac arrest, can replace first or second dose of epinephrine (40 units IV)

Source and review

  • Surviving Sepsis Campaign Guidelines 2021. Last reviewed: 2024-09-01