Vasopressin
Vasopressin (Antidiuretic Hormone, ADH) is the body's ultimate survival nonapeptide, synthesized in the hypothalamus and deployed from the posterior pituitary. In intensive care medicine, synthetic Vasopressin is the final-line hemodynamic rescue agent. It is pushed intravenously to violently reverse catastrophic vasodilatory organ shock, stabilize crashing blood pressures during septic collapse, and aggressively staunch massive esophageal variceal hemorrhaging.
Quick Stats
Scientific Data
Mechanism of Action
Vasopressin (also known as arginine vasopressin or AVP) is an endogenous nine-amino-acid peptide hormone synthesized in the hypothalamus and released by the posterior pituitary. It plays two critical life-saving roles: (1) stimulating V2 receptors in the kidneys to increase water reabsorption, controlling blood osmolarity; and (2) stimulating V1 receptors on vascular smooth muscle to induce profound vasoconstriction.
In critical care, synthetic vasopressin is administered via continuous IV infusion to treat vasodilatory shock (such as septic shock) that is unresponsive to catecholamines (epinephrine/norepinephrine), rapidly restoring mean arterial pressure.
Source: PMID: 10796661
Background & History
Vasopressin is one of the oldest known peptide hormones, discovered by Sir Henry Dale in 1906. Its dual role in water homeostasis and vascular tone makes it critical in both endocrinology and critical care medicine. In modern ICU practice, vasopressin has become a cornerstone vasopressor in septic shock, included in the Surviving Sepsis Campaign guidelines. Also used in advanced cardiac life support (ACLS) algorithms.
Research Use Cases
- ✓Septic shock
- ✓Cardiac arrest
- ✓Diabetes insipidus
- ✓Esophageal variceal hemorrhage
- ✓Catecholamine-resistant shock
Dosing Protocol
| Typical Dose | 0.01-0.04 units/min IV infusion |
| Frequency | Continuous IV infusion |
| Half-Life | 0.3 hours |
Dosing Protocols
Critical Care (Septic Shock)
Body-Weight Dosing Reference
Estimated doses extrapolated from the published research range of 10–40 mcg/day (referenced to 70 kg / 154 lb). These are approximations — consult a qualified healthcare provider for personalised guidance.
| Weight | Low Dose | Target Dose | High Dose |
|---|---|---|---|
| 120 lb(54 kg) | 8 mcg | 19 mcg | 31 mcg |
| 140 lb(63 kg) | 9 mcg | 22 mcg | 36 mcg |
| 160 lb(73 kg) | 10 mcg | 26 mcg | 42 mcg |
| 180 lb(82 kg) | 12 mcg | 29 mcg | 47 mcg |
| 200 lb(91 kg) | 13 mcg | 32 mcg | 52 mcg |
| 220 lb(100 kg) | 14 mcg | 36 mcg | 57 mcg |
| 250 lb(113 kg) | 16 mcg | 40 mcg | 65 mcg |
💉 For exact syringe units based on your vial concentration, use the Vasopressin Reconstitution Calculator →
Administration
Expected Timeline
Who Is It For?
Vasodilatory Shock
HighFront-line adjunctive therapy for septic shock and advanced cardiac life support.
Safety & Considerations
FDA-approved. Emergency hospital critical care use only. Can cause severe ischemia (restricted blood flow to heart or limbs) due to intense vasoconstriction.
Regulatory & Legal Status
Not currently on the WADA 2026 Prohibited List. Policies may change — verify before competition.
Research Chemical
US Compounding: Not eligible / not available
⚠️ This information is for educational purposes only and may not reflect the most current regulatory updates. Always verify with official FDA, WADA, and jurisdiction-specific sources before use.
Interactions & Contraindications
Potentiates effects of other vasopressors. May cause limb/mesenteric ischemia at high doses. Use caution with coronary artery disease. Terlipressin is a longer-acting synthetic analogue used in some countries.
Synergies & Common Stacks
Desmopressin is the clinically refined synthetic analogue with selective V2 agonism. Vasopressin acts on V1a, V2, and V1b receptors for broader hemodynamic effects.
Dosing Quick Reference
Frequently Asked Questions
Why is vasopressin used in sepsis?▼
References
- Russell JA et al. “"Vasopressin versus norepinephrine infusion in patients with septic shock".” NEJM (2008). PMID: 18305265
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