Uses

Diabetes Insipidus

Prevention or control of polydypsia, polyuria, and dehydration in diabetes insipidus caused by a deficiency of endogenous posterior pituitary ADH (neurohypophyseal diabetes insipidus), but desmopressin usually considered drug of choice.

May be used in the initial or emergency treatment of the disease, but, because of its short duration of action, its use is impractical for chronic therapy.

Intranasal aqueous vasopressin may be effective for daily maintenance therapy and the degree of absorption is usually adequate to control mild diabetes insipidus; other drugs are preferred (e.g., chlorpropamide).

Polyuria

May correct fluid imbalance associated with transient polyuria due to ADH deficiency accompanying neurosurgery or head injury.

Not effective in controlling polyuria caused by renal disease, nephrogenic diabetes insipidus, hypokalemia or hypercalcemia, or polyuria secondary to the administration of demeclocycline or lithium carbonate.

CPR

Used for its vasopressor effects; may give 1 dose to replace first or second dose of epinephrine in ACLS during CPR.

Comparably effective to epinephrine in patients with cardiac arrest (presented with VF or pulseless electrical activity); however, conflicting evidence exists whether vasopressin is more effective than epinephrine in patients with asystolic cardiac arrest.

May enhance the probability of return of spontaneous circulation (ROSC), survival to hospital admission, as well as hospital discharge.

Combination of vasopressin and epinephrine (if refractory) has been reported to be more effective than repeated epinephrine alone for refractory cardiac arrest; however, optimal timing of vasopressin administration in relation to epinephrine use during cardiac arrest not fully established (i.e., replacement of first versus second epinephrine dose).

Drug-induced cardiovascular emergencies or altered vital signs: Has been used in drug-induced distributive shock†.

Has been used rarely in severely hypotensive patients with anaphylaxis†; potential therapy to prevent cardiopulmonary arrest.

Abdominal Distention

To stimulate peristalsis in the prevention or relief of intestinal paresis, postoperative abdominal distention, and distention complicating pneumonias or toxemias.

Abdominal Radiographic Procedures

To dispel interfering gas shadows and/or to concentrate the contrast media prior to abdominal radiographic procedures including IV urography, cholecystography, and kidney biopsy.

Diagnostic Uses

Although vasopressin injection has been used as a provocative test for pituitary release of growth hormone and corticotropin†, arginine hydrochloride and insulin generally are considered the most reliable diagnostic indicators of growth hormone reserve.

GI Hemorrhage

Administered IV† or intra-arterially† into the superior mesenteric artery as an adjunct in the treatment of acute and life-threatening, massive GI hemorrhage† caused by ruptured esophageal varices (e.g., in alcohlic cirrhotics), peptic ulcer disease, esophagogastritis, esophageal laceration, acute gastritis, colitis associated with Behcet’s disease, colonic diverticulosis, small intestinal typhoid infection, Mallory-Weiss syndrome, or intestinal perforation.

Infused into the mesenteric artery† prior to and during portosystemic shunt surgery for esophageal varices†.

May provide effective control of bleeding, but there is no evidence that the drug substantially improves overall survival.

Should not preclude use of other measures (e.g., blood transfusions, esophageal tamponade, paracentesis, ice water gavage, sclerotherapy, emergency surgery) when indicated.

Vasodilatory Shock

May consider for hemodynamic support as a continuous infusion† in vasodilatory shock† such as septic shock and sepsis syndrome, if conventional adrenergic vasopressor drugs are ineffective.