Expert Opin Pharmacother. 2023 Aug 3. doi: 10.1080/14656566.2023.2244427. Online ahead of print.
INTRODUCTION: Terlipressin is a synthetic vasopressin analogue which has been recently been approved in the United States by the Food and Drug Administation for the treatment of hepatorenal syndrome.Terlipressin stimulates vasopressin receptors located on the smooth muscle vasculature of the splanchnic circulation and renal tubules which results in splanchnic vasoconstriction with improved renal perfusion and antidiuretic activity, respectively.
AREAS COVERED: In this review, we discuss available data regarding the FDA approved use of terlipressin, safety and tolerability, as well as highlight alternative uses in chronic liver disease currently still under investigation.
EXPERT OPINION: Terlipressin is more efficious compared to other vasoactive agents including midodrine octreotide and norepinephrenine in reversal of hepatorenal syndrome and improves short term survival. Other potential applications of terlipressin's vasoconstrictor actions reported in the literature include management of variceal hemorrhage and other complications of portal hypertension.