Vasopressin (Pitressin®)

Updated May 4, 2014
Author: Cardiac

Description: A brief outline for the drug vasopressin; not intended to be complete


 Vasopressin is a naturally occurring antidiuretic hormone. In high doses, vasopressin acts as a non-adrenergic peripheral vasoconstrictor.


10cc Multi-dose vial: 20 Units/ml.

When given during CPR, vasopressin increases coronary perfusion pressure, vital organ blood flow, ventricular fibrillation (VF) median frequency, and cerebral oxygen delivery. Used as a Class 2b medication for pulseless VT/VF    

-may be more effective than epinephrine as a pressor agent for promoting the return of spontaneous circulation in cardiac arrest.     

- may be used as an alternative pressor to epinephrine in the treatment of adult shock-refractory VF    

- may be useful for hemodynamic support in vasodilatory shock (e.g., septic shock, anaphylaxis). Evidence in human clinical trials is limited, but has been consistently positive. The lower adverse effects profile of vasopressin may be the major reason for use.

Vasopressin is not recommended for responsive patients with coronary artery disease because the increased peripheral resistance may provoke angina pectoris.

Vasopressin is administered as a single bolus dose of 40 units intravenously.

for Pulseless VT/VF

-for Pulseless VT/VF: (ACLS Guidelines 2002)    

- a single dose/push of vasopressin 40 IU IV (long half-life). Currently, vasopressin is only recommended to be given once.     

- after 10 to 20 minutes, if there is no clinical response to vasopressin, epinephrine 1 mg every 3 to 5 minutes can be given. 

as a Drip in Cardiac Surgery

used to provide increased SVR during milrinone administration

100 units vasopressin/100 cc comes from pharmacy pre-mixed

run @ 2.4 cc/hr (0.04 units/min); dose is NOT weight dependent

convert IVAC multi-channel pump to neonatal to allow decimals in rate (More Options-> Device->Neonatal)

as a Drip in Hypotension (esp. if refractory to phenylephrine)

Rebound Hypertension after Cessation of Vasopressin