Terlipressin remains indispensable in two indications

Czech version

Authors: H. Gottfriedová
Authors‘ workplace: Klinika hepatogastroenterologie, Transplantcentrum, IKEM, Praha
Published in: Gastroent Hepatol 2018; 72(2): 129-133
Category: Hepatology: Review article
doi: https://doi.org/10.14735/amgh2018129

Overview

Terlipressin was first synthesized more than 54 years ago in former Czechoslovakia. This drug has potent vasoconstrictive and antibleeding effects, which reduce portal pressure and flow in portosystemic shunts, and can be administered in individual doses rather than continuously. Terlipressin is used in clinical practice primarily to treat acute variceal bleeding and hepatorenal syndrome. Other indications include bleeding due to portal gastropathy and bleeding from the gastrointestinal and urogenital tracts in children and in adults, and this drug is also locally applied during gynecological operations on the uterine cervix. Acute variceal bleeding is currently treated according to clearly established procedures and should be initiated upon first contact with the patient. Use of terlipressin in this indication reduces mortality and the risk of bleeding recurrence. Terlipressin is the preferred drug for treatment of hepatorenal syndrome and reduces mortality and improves kidney function in patients with hepatorenal syndrome type 1 and 2. There is no recommended dosage schedule of terlipressin in hepatorenal syndrome patients and the treatment duration is not clearly established. Recurrence of hepatorenal syndrome after discontinuation of terlipressin is usually resolved by re-administration of the drug. The main side effects of terlipressin are myocardial, splanchnic, and acral ischemia.

Key words:
terlipressin – portal hypertension – variceal bleeding – hepatorenal syndrome

The author declares she has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
21. 1. 2018

Accepted:
5. 3. 2018

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