argipressin acetate: clinical use

Prescribing considerations

• Confirm that diabetes insipidus is not nephrogenic.
• Assess cardiovascular, peripheral vascular and renal disease before use.
• Use particular caution with systemic hypertension, epilepsy, migraine, asthma, heart failure or states where rapid extracellular fluid expansion would be hazardous.
• The selected product is not recommended below 18 years.

Contraindications and cautions

• Hypersensitivity or previous anaphylaxis to argipressin or an excipient.
• Vascular disease, particularly coronary artery disease.
• Planned use of halogenated anaesthetic agents.
• Chronic nephritis with nitrogen retention until acceptable blood nitrogen concentrations are attained.

Monitoring

• Watch for headache, drowsiness or listlessness suggesting water intoxication and assess fluid balance.
• Monitor blood pressure and for myocardial ischaemia.
• Inspect peripheral skin and circulation for ischaemia where vascular disease is present.
• Use urine osmolality to guide treatment immediately after hypophysectomy.
• Monitor blood urea nitrogen in chronic nephritis.

Clinical pharmacology

Argipressin increases renal tubular water reabsorption and directly contracts vascular smooth muscle. It is rapidly metabolised, mainly in the liver and kidneys, and has a short plasma half-life.

Formulation and product differences

• The selected product is a clear, sterile solution for injection containing glacial acetic acid and water for injection.
• It may be administered subcutaneously, intramuscularly or intravenously according to indication.
• Ampoules are single-use, require refrigerated storage, must not be frozen and should be protected from light.
• Compatibility with other medicines has not been established, so it should not be mixed unless compatibility is specifically supported.