argipressin: clinical use

Prescribing considerations

• Confirm that diabetes insipidus is not due to renal resistance to vasopressin.
• Use extreme caution in systemic hypertension, heart failure or vascular disease because myocardial or peripheral ischaemia may occur.
• Use cautiously in epilepsy, migraine, asthma and conditions where rapid extracellular-water expansion would be hazardous.
• The selected product is not recommended for people younger than 18 years.

Contraindications and cautions

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

Monitoring

• Assess fluid balance and watch for headache, listlessness, drowsiness or other evidence of water intoxication.
• Monitor blood pressure and evidence of myocardial or peripheral ischaemia; inspect skin perfusion where peripheral vascular disease is present.
• Use urine osmolality to guide management 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, with a plasma half-life of approximately 10–20 minutes.

Formulation and product differences

• The selected product is a clear, sterile solution for injection in single-use glass ampoules.
• It contains glacial acetic acid and water for injections.
• Do not mix with other medicines, as compatibility studies are absent.
• Store refrigerated, protect from light and do not freeze; discard any unused remainder.

Injection

Route: Parenteral

Strengths: 20 units/mL