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Argipressin (EMBESIN brand) Intravenous Infusion for Adults (analogue of vasopressin)

Who can administer

Administration RESTRICTED - see Appendix 1

Important information

  • ARGIPRESSIN is the synthetic analogue of VASOPRESSIN.  The two terms may be used interchangeably
  • This monograph refers only to the Embesin™ brand. Other brands of argipressin/vasopressin require different dilutions- contact pharmacy in the event alternative preparations are being used
  • For use in critical care areas only
  • Take great care to ensure the correct product and dilution is being used, and that infusion pump settings are correct

Available preparations

Embesin 40 units per 2ml ampoule (argipressin)

Reconstitution

Already in solution

Draw up using a 5 micron filter needle

Infusion fluids

Glucose 5% (preferred) (ref 1) or Sodium chloride 0.9%

Methods of intravenous administration

Continuous intravenous infusion (using an electronically controlled infusion device)

  • Add 40 units (2ml) to 48ml infusion fluid - note change in concentration from previous products
  • Administer via central-line (ref 1)

Dose in adults

Septic shock (in addition to conventional vasopressor therapy with catecholamines)

  • Ideally started within the first six hours after the onset of septic shock, or within 3 hours of onset in patients on high doses of catecholamines
  • Administer at a rate of 0.01 units per minute (0.75ml/hour of a 40 unit/50ml solution).
  • Dependent on the clinical response, the dose may be increased every 15 to 20 minutes up to 0.03 units per minute (2.25ml/hour of 40 unit/50ml solution)
  • Doses above 0.03 units per minute should only be used as emergency treatment, as this may cause gut and skin necrosis and increase the risk of cardiac arrest
  • The treatment duration should be chosen according to the individual clinical picture but should preferably last for at least 48 hours
  • Treatment with argipressin must not be discontinued abruptly but should be weaned off gradually in accordance with the clinical course of the patient
  • Administer via central line only

Monitoring

  • Myocardial and gut ischaemia, myocardial and gut infarction and reduced perfusion of the extremities have been known to occur

Storage

  • Store between 2 to 8°C

References

SPC Embesin 13th October 2022

1: Injectable medicines guide, accessed via Medusa 17th October 2022

Therapeutic classification

Posterior pituitary hormones and antagonists