INDICATIONS

• Treatment of bleeding oesophageal varices

DOSAGE AND ADMINISTRATION

Adults:- Initially 1-2 mg terlipression acetate are administered.

Depending on the patient’s body weight the dose can be adjusted as follows:-

• After the initial injection, the dose can be reduced to 1 mg every 4 to 6 hours.
• The approximate value for the maximum daily dose of terlipressin acetate 1 mg solution for injection is 120 µg/ kg body weight.
• The therapy is to be limited to 2-3 days in adaptation to the course of the disease.
• Terlipressin injection is injected IV and should be given during the period of 1 minute.

Renal insufficiency- Terlipressin injection should only be used with caution in patients with chronic renal failure. Hepatic insufficiency- A dose adjustment is not required in patients with liver failure.

Elderly- Terlipressin injection should only be used with caution in patients over 70 years

Children and adolescents- Terlipressin injection is not recommended in children and adolescents due to sufficient experience on safety and efficacy

Terlipressin has stood the test of time: Clinical overview in 2020 andfuture perspectives

• Terlipressin is an effective drug for hepatorenal syndrome reversal in cirrhosis and acute on chronic liver failure (ACLF) patients.
• Terlipressin is effective in controlling acute variceal bleeding with a mortality benefit.
• Terlipressin can also be used in refractory ascites, hepatic hydrothorax, septic shock, paracentesis-induced circulatory dysfunction and perioperatively during liver transplantation and hepatabiliary surgery. However, terlipressin is not recommended for such indications (outside research seƫngs)
• Continuous terlipressin infusion through an elastomeric infusion pump may be utilised for patients with refractory ascites and HRS-2