Abstract | BACKGROUND/AIMS:
Terlipressin is a long-acting vasopressin analogue that has been proved useful in the treatment of variceal haemorrhage. This study investigates the time profile of the haemodynamic effects of terlipressin on portal hypertension as well as the efficacy in decreasing portal-pressure and collateral blood flow of reduced doses, suitable for longer therapy to prevent early rebleeding. METHODS: RESULTS: Placebo caused no significant effects. At 30 min of terlipressin administration, the hepatic venous pressure gradient (1 mg: -16+/-9%, 2 mg: -21+/-11%; p<0.01) and azygos blood flow (1 mg: -19+/-13%, 2 mg: -25+/-17%; p<0.05) were significantly reduced. These effects were still significant at 4 h (2 mg) or 3 h (1 mg). Both doses moderately increased arterial pressure at 1 h. At 4 h, neither arterial pressure nor peripheral vascular resistance was significantly modified by either dose of terlipressin. Terlipressin caused no significant changes in hepatic blood flow. CONCLUSIONS: In patients with cirrhosis, a single injection of 2 mg of terlipressin significantly and markedly reduces portal pressure and azygos blood flow for up to 4 h. The effects of a reduced dose (1 mg) were almost as pronounced and prolonged, suggesting that after the initial control of variceal bleeding, terlipressin therapy could be maintained for several days at low dosage to reduce the risk of early rebleeding.
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Authors | A Escorsell, J C Bandi, E Moitinho, F Feu, J C García-Pagan, J Bosch, J Rodés |
Journal | Journal of hepatology
(J Hepatol)
Vol. 26
Issue 3
Pg. 621-7
(Mar 1997)
ISSN: 0168-8278 [Print] Netherlands |
PMID | 9075670
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antihypertensive Agents
- Lypressin
- Terlipressin
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Topics |
- Adult
- Aged
- Antihypertensive Agents
(administration & dosage, therapeutic use)
- Dose-Response Relationship, Drug
- Double-Blind Method
- Esophageal and Gastric Varices
(complications, physiopathology)
- Female
- Follow-Up Studies
- Gastrointestinal Hemorrhage
(etiology, physiopathology, prevention & control)
- Hemodynamics
(drug effects)
- Humans
- Hypertension, Portal
(complications, drug therapy, physiopathology)
- Infusions, Intravenous
- Liver Cirrhosis
(complications, physiopathology)
- Lypressin
(administration & dosage, analogs & derivatives, therapeutic use)
- Male
- Middle Aged
- Recurrence
- Splanchnic Circulation
(drug effects)
- Terlipressin
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