GLIPRESSINA ® is a Terlipressin-based drug
THERAPEUTIC GROUP: Hormones of the posterior lobe of the pituitary
Indications GLIPRESSINA ® - Terlipressin
GLIPRESSINA ® is used in the prevention and treatment of bleeding from esophageal varices.
Mechanism of action GLIPRESSIN ® - Terlipressin
Terlipressin, active principle of GLIPRESSINA ® is a synthetic analogue of vasopressin characterized by the addition of three glycine molecules on the terminal side of the protein.
This small structural variation gives terlipressin a particular mode of action, which allows the active principle to gradually get rid of the amino acid tail, exerting a predominantly vasoconstrictive rather than antidiuretic action.
The aforementioned biological property, concentrated above all at the splanchnic level, allows to reduce the blood flow entering the portal vein, reducing the portal pressure, therefore backwards that existing inside the esophageal varices, counteracting bleeding without affecting the blood coagulation dynamics.
The activity of terlipressin is also more prolonged than that of its analogue, allowing a duration of action that exceeds 4 hours.
Studies carried out and clinical efficacy
1. TERLIPRESSIN IN THE TREATMENT OF PATIENTS WITH CIRRUSIS AND REFRACTORY ASCITES
Eur J Intern Med. 2011 Dec; 22 (6): 587-90. Epub 2011 Aug 2.
The use of terlipressin in cirrhotic patients with refractory ascites and normal renal function: A multicentric study.
Fimiani B, Guardia DD, Puoti C, Adamo GD, Cioffi O, Pagano A, Tagliamonte MR, Izzi A.
Prospective study evaluating the efficacy of adding terlipressin to the treatment of cirrhotic patients with refractory ascites and normal renal function. The treatment combined with diuretics and albumin proved effective, reducing the degree of ascites by two points, and at the same time preserving the patient from potential esophageal bleeding.
2. TERLIPRESSIN / EPINEPHRINE IN CARDIAC ARREST
Pediatr Emerg Care. 2011 Sep; 27 (9): 865-8.
Beneficial effects of terlipressin in pediatric cardiac arrest.
Yilidzdas D, Horoz OO, Erdem S.
Emergency medicine work demonstrating how the combined adrenaline / terlipressin treatment can be beneficial in the treatment of children with cardiac arrest.
3. CASE REPORT, BLOODING AND TERLIPRESSIN
Reumatol Clin. 2011 Jan-Feb; 7 (1): 59-60. Epub 2010 Dec 17.
Sildenafil in severe peripheral ischemia induced by terlipressin. A case report.
Bañuelos Ramírez DD, Sánchez Alonso S, Ramírez Palma MM.
Case report in which an attempt was made to treat prerenal acute renal failure due to gastrointestinal bleeding unresponsive to conventional therapy, with terlipressin. Partial results were improved with oral Sildenafil administration.
Method of use and dosage
GLIPRESSINA ® powder and solvent for solution for injection for intravenous use of 1 mg terlipressin acetate:
the need for intravenous administration of the active principle and the surgical context of the pathology require hospital therapeutic intervention.
It will therefore be the task of the specialist doctor to define the appropriate dosage, based on the severity of the bleeding or the preventive aspect.
Warnings GLIPRESSINA ® - Terlipressina
It is useful to remember that the treatment with GLIPRESSINA ® is an advanced therapeutic act, which requires the continuous supervision of health personnel, within a hospital facility equipped for surgical emergencies.
Blood pressure, heart rate and plasma electrolytes are the main parameters to be monitored throughout the treatment.
PREGNANCY AND BREASTFEEDING
The absence of data relating to the safety of terlipressin on the health of the fetus when taken during pregnancy limits the use of GLIPRESSINA ® both during the gestational period and in the subsequent lactation phase.
Interactions
There are currently no clinically relevant drug interactions capable of varying the pharmacokinetic profile of terlipressin and its biological efficacy.
Contraindications GLIPRESSINA ® - Terlipressin
The use of GLIPRESSINA ® is contraindicated in case of hypersensitivity to the active ingredient, coronary insufficiency, history of myocardial infarction, altered heart rhythm, hypertension and during pregnancy and lactation.
Undesirable Effects - Side Effects
Intravenous administration of GLIPRESSINA ® may be accompanied by side effects such as intense abdominal pain, hypertensive spikes and contraction of diuresis.
On the other hand, skin vasoconstriction, nausea and headache observed after taking terlipressin are of lesser clinical interest.
Notes
GLIPRESSINA ® is reserved for hospital use.
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