Terlipressin
About Terlipressin
Terlipressin is a prescription injection primarily used to treat life-threatening bleeding in the food pipe (oesophageal varices) and a severe type of kidney failure linked to advanced liver disease. It works by narrowing the blood vessels in the stomach area, which reduces pressure in the liver and helps control dangerous bleeding.
Because this medicine is given as an injection directly into a vein, it is strictly managed by healthcare professionals in a hospital setting. It is given at regular intervals based on your clinical condition, and you do not need to worry about taking it with food. While receiving this treatment, staying hydrated under medical supervision and adhering to a low-sodium diet can help support your liver and kidneys.
Common side effects of Terlipressin include abdominal cramps, pale skin, headaches, and a temporary increase in blood pressure. However, you must inform your healthcare team immediately if you experience severe chest pain, difficulty breathing, or bluish discolouration of your fingers or toes.
Before receiving Terlipressin, it is vital to tell your doctor if you have a history of heart disease, irregular heartbeats, high blood pressure, or breathing problems like asthma. Do not take this if you are pregnant, as it can cause harm to the unborn baby, or if you have severe, uncontrolled heart conditions.
This medicine can interact with other drugs that affect your heart rhythm or blood pressure, so a complete list of your current medications must be reviewed by your medical team. Additionally, because it is used for severe liver-related emergencies, avoiding alcohol and smoking is absolutely critical for your recovery. Pregnant or breastfeeding women, as well as elderly individuals with heart conditions, must discuss the risks and benefits thoroughly with their doctor before receiving this treatment.
Uses of Terlipressin
Medicinal Benefits
Terlipressin is used to control bleeding from oesophageal varices and to treat hepatorenal syndrome in patients with advanced liver disease. It works by narrowing specific blood vessels, reducing portal vein pressure, and improving blood flow to vital organs.
- Controls Variceal Bleeding: Helps rapidly reduce pressure in the portal vein, controlling bleeding from enlarged veins in the oesophagus.
- Supports Kidney Function: Improves blood flow to the kidneys in patients with hepatorenal syndrome, helping restore kidney function and urine production.
- Stabilises Medical Emergencies: Helps stabilise patients with severe liver-related complications, allowing time for additional treatments such as endoscopic procedures.
- Reduces Portal Hypertension: Lowers increased pressure within the portal venous system, helping reduce the risk of further bleeding episodes.
- Improves Treatment Outcomes: When used as part of standard medical care, it helps improve the management of serious complications associated with advanced liver disease.
Directions for Use
- Follow your doctor’s instructions on the dosage and timing of this medication to ensure safe and effective use.
- Terlipressin will be administered intravenously by the doctor or healthcare professional in a medical setting.
- Do not self-administer.
Storage
Side Effects of Terlipressin
Common Side Effects (Usually mild):
- Abdominal pain or cramping
- Diarrhoea
- Headache
- Pale skin
- Slow heart rate
Serious Side Effects (Call a doctor right away):
- Severe chest pain or tightness
- Difficulty breathing or severe shortness of breath
- Bluish colour in the fingers, toes, or skin
- Signs of an allergic reaction (such as swelling of the face, lips, or throat, or severe skin rash)
- Sudden, severe high blood pressure
Medicines Containing this Salt
View AllDrug Warnings
- Monitor injection sites: If you feel pain, burning, redness, or swelling where the injection is being given, tell your healthcare provider immediately to prevent skin damage.
- Check the solution: Before use, the medical provider should visually inspect the solution to ensure it is clear, colourless, and free of any visible particles.
- Keep a close eye on breathing: Alert your doctor immediately if you feel short of breath, as this medicine can sometimes cause fluid to build up in your lungs.
- Avoid sudden movements: Gently change positions (such as sitting up or standing up slowly) as your blood pressure can fluctuate during treatment.
Drug Interactions
Inform your doctor if you are taking any of the following medicines before receiving Terlipressin:
- Heart rhythm medications (like beta-blockers): Combined use may cause your heart rate to drop to dangerously slow levels.
- Blood pressure medications: Taking these alongside Terlipressin can cause unpredictable fluctuations in your blood pressure.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
consult your doctorThe interaction of Terlipressin with alcohol is unknown. Therefore, if you have any concerns regarding this, please discuss them with your doctor.
Pregnancy
consult your doctorLimited data available on the effect of Terlipressin on pregnant women. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Terlipressin. Your doctor may give this medicine if the benefits outweigh the risks.
Breast Feeding
consult your doctorIt is unknown whether Terlipressin is excreted in breast milk. Hence, if you are a nursing mother, inform your doctor before receiving Terlipressin. Your doctor may give this medicine if the benefits outweigh the risks.
Driving
cautionLimited information is available. However, if you are unwell after receiving Terlipressin, avoid driving or operating machinery.
Liver
consult your doctorIf you have any liver problems, inform your doctor before receiving Terlipressin.
Kidney
cautionTerlipressin should be used with caution in patients with long-standing kidney failure. Also, inform your doctor if you have impaired kidney function.
Children
unsafeTerlipressin is not recommended for children and adolescents as the safety and effectiveness were not established.
Habit Forming
Diet & Lifestyle Advise
- Follow a strict low-sodium diet: Reducing your salt intake is crucial to prevent your body from holding onto excess fluid, which can worsen liver and kidney complications.
- Limit or restrict fluid intake: If recommended by your doctor, monitor and limit the amount of fluids you drink to avoid fluid overload, which can put extra strain on your heart and lungs.
- Avoid alcohol completely: Alcohol causes direct liver damage and can worsen bleeding in your food pipe. Completely avoiding alcohol is essential for your recovery and long-term health.
- Rest and limit physical strain: Avoid heavy lifting or intense physical exertion, as sudden strain can increase pressure in your abdominal veins and raise the risk of bleeding.
Patients Concern
Disease/Condition Glossary
Bleeding oesophageal varices: These occur when varices (swollen veins) in the lower oesophagus (food pipe) rupture and bleed. When liver blood flow is obstructed, blood builds up in other blood vessels nearby, including those in the lower oesophagus. This causes blood vessels to dilate and swell as a result of the increased blood flow. The swollen veins are known as oesophageal varices which may leak blood and rupture eventually. Often, it does not cause any symptoms until they rupture and bleed. If the bleeding is mild, the symptoms include black, tarry stools, and if the bleeding is severe, the symptoms include stomach pain, blood in your vomit, rectal bleeding, lightheadedness, and bloody stools.
FAQs
Terlipressin is used to treat Bleeding oesophageal varices.
Terlipressin contains Terlipressin, a synthetic pituitary hormone that works by narrowing the affected blood vessels and restricting the blood flow through them. Thus, it helps to control bleeding.
You are recommended to consult a doctor before taking quinidine while on treatment with Terlipressin as it may increase the risk or severity of QT prolongation (a heart rhythm disorder). Therefore, please consult a doctor before taking other medicines with Terlipressin.
Terlipressin may cause headaches as a common side effect. However, if the condition persists or worsens, please inform your doctor.
The side effects of Terlipressin include abdominal cramps, diarrhoea, high or low blood pressure, slow heart rate, headache, pale skin, and insufficient blood circulation in arms, legs and skin. Consult the doctor if any of these symptoms persist or worsen.
Terlipressin should not be taken if you are allergic to any of its ingredients, experiencing hypoxia (low levels of oxygen) or worsening respiratory symptoms, or have ongoing coronary, peripheral, or mesenteric ischemia (conditions affecting blood flow).
Before taking Terlipressin, let your doctor know if you have severe bleeding in the oesophagus (food pipe). If you have a severe infection like septic shock, breathing issues such as asthma, uncontrolled high blood pressure, heart problems (angina, arrhythmias, or a history of heart attack), poor blood circulation (to the brain or limbs), kidney impairment, electrolyte imbalances, significant fluid or blood loss, if you are pregnant, or are over 70 years old.
Terlipressin will be given as a continuous intravenous infusion by the doctor or nurse. Do not self-administer.
Terlipressin is not recommended for children as its safety and effectiveness were not established.
No, Terlipressin must be given in a hospital or specialised clinic setting by a trained healthcare professional because it requires continuous monitoring of your heart, blood pressure, and kidneys. Talk to your doctor if you have questions about your treatment setting.
This medicine works by narrowing your blood vessels, which temporarily reduces blood flow to the surface of your skin, making you look pale. This is a common effect and usually resolves after the treatment ends. Talk to your doctor if you are concerned.
No, you should not receive Terlipressin if you are pregnant. It can cause the muscles of the uterus to contract, which can harm the pregnancy or cause early labour. Talk to your doctor about alternative options.
No, Terlipressin does not cure liver disease. It is an emergency treatment used to manage severe complications of liver disease, such as bleeding veins in the food pipe or temporary kidney failure. Talk to your doctor about long-term management for your liver condition.
A slow heart rate is a known side effect of this medicine. Your healthcare team will continuously monitor your heart rate during the injection and will take action if it drops too low. Talk to your doctor or nurse if you feel dizzy or lightheaded.
It is not fully known if Terlipressin passes into breast milk. If you are breastfeeding, you must discuss the risks and benefits with your healthcare team before receiving this medication. Talk to your doctor or pharmacist for guidance.
Yes, in some cases, Terlipressin can cause fluid to build up in the body, which can lead to shortness of breath or fluid in the lungs. Your doctor will monitor your fluid levels and breathing closely during treatment. Talk to your doctor if you have a history of asthma or breathing issues.
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