Library · Heart, blood & kidney · Hepatorenal syndrome, variceal bleeding
Terlipressin
Terlivaz
A synthetic vasopressin analogue selective for V1 receptors, FDA-approved in 2022 as the first drug specifically for improving kidney function in hepatorenal syndrome. It lowers portal pressure and improves renal blood flow, given for up to 14 days or until kidney function markers normalize.
Research score 83/100. Reference only, not a dose.
Boxed warning: Risk of respiratory failure. Continuous monitoring required
- Vasoconstriction
- Renal Function Improvement
- US status
- Prescription Only
- Approval
- FDA Approved (2022)
- Evidence
- CONFIRM trial: significant improvement in HRS reversal (55% vs 4.8% midodrine-octreotide)
- Research score
- 83 / 100
- Indication
- Hepatorenal syndrome type 1
- Origin
- United States
- Source category
- Cardiovascular & Renal
- Status group
- Approved / prescription
Mechanism
Selectively activates V1 receptors, reducing portal pressure and raising effective blood volume and arterial pressure, which improves the kidneys' filtration rate.
Safety file
Serious risks include respiratory failure, requiring continuous oxygen monitoring; avoided in patients with heart dysfunction or fluid overload.
- Abdominal pain
- Nausea
- Respiratory failure
- Diarrhea
- Dyspnea