Glipressina (Terlipressin)

Glipressina is the brand name for the intravenous formulation of terlipressin, a synthetic vasopressin analog used as a hemodynamic agent. It is supplied as a prescription‑only product in the European Union and is classified under ATC code C01DA03. As a V1‑receptor agonist, Glipressina produces vasoconstriction and raises systemic vascular resistance, which supports its use in specific hepatic and gastrointestinal emergencies clinical settings for critical care.

Glipressina is indicated for the management of two serious conditions where rapid hemodynamic control is required.

- Hepatorenal syndrome type 1 in patients with advanced cirrhosis, to improve renal perfusion and function. - Acute variceal bleeding associated with portal hypertension, to achieve hemostasis and reduce re‑bleeding risk. - As a bridge therapy in liver transplantation candidates with refractory circulatory failure. - In selected cases of septic shock unresponsive to conventional vasopressors, under specialist supervision.

Adverse reactions to Glipressina reflect its vasoconstrictive activity and may vary from mild to severe.

Common: - Headache - Nausea or vomiting - Abdominal pain or cramps - Flushing or warmth at the infusion site

Serious: - Ischemic complications such as myocardial infarction or peripheral limb ischemia - Severe hypertension or hypertensive crisis - Cardiac arrhythmias, including tachycardia or bradycardia

Because Glipressina influences vascular tone and organ perfusion, several precautions should be observed before and during therapy.

- Assess cardiovascular status; avoid use in uncontrolled hypertension or recent myocardial infarction. - Monitor renal function and electrolytes, especially in patients with pre‑existing kidney disease. - Use cautiously in patients with coronary artery disease or peripheral vascular disease. - Evaluate for signs of ischemia, particularly in the extremities and gastrointestinal tract. - Adjust or discontinue therapy if severe hypertension or arrhythmias develop. - Pregnancy and lactation status are unknown; avoid use unless benefits outweigh potential risks.

Glipressina may interact with other agents that affect vascular tone, cardiac function, or renal perfusion.

Avoid: - Concomitant use with other potent vasoconstrictors (e.g., norepinephrine, phenylephrine) due to additive hypertension risk. - Combination with vasodilators such as nitroglycerin or hydralazine that may blunt therapeutic effect.

Use with caution: - Concurrent administration of beta‑blockers, which can mask tachycardia signs. - Diuretics or nephrotoxic drugs, as renal perfusion changes may exacerbate kidney injury. - Anticoagulants, because gastrointestinal ischemia can increase bleeding risk.