Table 6

Vasoconstrictor drugs for the treatment of hepatorenal syndrome

Drug

Dose


Terlipressin [60-78]

0.5 to 2.0 mg intravenously every 4 to 6 hours; with stepwise dose increments every few days if there is no improvement in serum creatinine, up to a maximum dose of 12 mg/day as long as there are no side effects. Maximal treatment 14 days

Vasopressin [81]

0.01 U/min to 0.8 U/min (continuous infusion). Titrate to achieve a 10 mm Hg increase in MAP from baseline or MAP > 70 mmHg

Noradrenaline [69,77,80]

0.5 to 3.0 mg/hour (continuous infusion). Titrate to achieve a 10 mmHg increase in MAP

Midodrine + Octreotide [82-87]

Midodrine: 7.5 to 12.5 mg orally three times. Titrate to achieve a 15 mm Hg increase in MAP from baseline

Octreotide:100 to 200 μg subcutaneously three times daily or 25 μg bolus, followed by intravenous infusion of 25 μg/hour


MAP: mean arterial pressure

Nadim et al. Critical Care 2012 16:R23   doi:10.1186/cc11188

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