Farpresin

Farpresin

vasopressin

Manufacturer:

Fahrenheit
Full Prescribing Info
Contents
Vasopressin.
Description
Each mL contains: Vasopressin 20 unit.
Farpresin (Vasopressin Injection, USP) Synthetic is a sterile, aqueous solution of synthetic vasopressin (8-Arginine vasopressin) of the posterior pituitary gland. It is substantially free from the oxytocic principle and is standardized to contain 20 pressor units/mL. The solution contains 0.5% Chlorobutanol (chloroform derivative) as a preservative. The acidity of the solution is adjusted with acetic acid.
Action
Pharmacology: The antidiuretic action of vasopressin is ascribed to increasing reabsorption of water by the renal tubules. Vasopressin can cause contraction of smooth muscle of the gastrointestinal tract and of all parts of the vascular bed, especially the capillaries, small arterioles, and venules with less effect on the smooth musculature of the large veins. The direct effect on the contractile elements is neither antagonized by adrenergic blocking agents nor prevented by vascular denervation. Following subcutaneous or intramuscular administration of vasopressin injection, the duration of antidiuretic activity is variable but effects are usually maintained for 2 to 8 hours. The majority of a dose of vasopressin is metabolized and rapidly destroyed in the liver and kidneys. Vasopressin has a plasma half-life of about 10 to 20 minutes. Approximately 5% of a subcutaneous dose of vasopressin is excreted in urine unchanged after 4 hours.
Indications/Uses
Farpresin is indicated for prevention and treatment of postoperative abdominal distention, in abdominal roentgenography to dispel interfering gas shadows, and in diabetes insipidus.
Dosage/Direction for Use
Farpresin may be administered subcutaneous, intramuscularly, intravenously or intraarterially, intranasal use, especially for the treatment of diabetes insipidus has been reported. Ten units of Farpresin (0.5 mL) will usually elicit full physiologic response in adult patients; 5 units will be adequate in many cases. Farpresin should be given intramuscularly at 3- or 4-hour intervals as needed. The dosage should be proportionately reduced for pediatric patients. (For an additional discussion of dosage, consult the sections as follows). When determining the dose of Farpresin for a given case, the following should be kept in mind. It is particularly desirable to give a dose not much larger than is just sufficient to elicit the desired physiologic response. Excessive doses may cause undesirable side effects-blanching of the skin, abdominal cramps, nausea-which, though not serious, may be alarming to the patient. Spontaneous recovery from such side effects occurs in a few minutes. it has been found that one or two glasses of water given at the time Farpresin is administered reduce such symptoms.
Abdominal Distention: In the average postoperative adult patient, give 5 units (0.25 mL) initially; increase to 10 units (0.5 mL) at subsequent injections if necessary. lt is recommended that Farpresin be given intramuscularly and that injections be repeated at 3- or 4-hour intervals as required. Dosage to be reduced proportionately for pediatric patients. Farpresin used in this manner will frequently prevent or relieve postoperative distention. These recommendations apply also to distention complicating pneumonia or other acute toxemias.
Abdominal Roentgenography: For the average case, two injections of 10 units each (0.5 mL) are suggested. These should be given two hours and one-half hour, respectiveiy, before films are exposed. Many roentgenologists advise giving an enema prior to the first dose of Farpresin.
Diabetes Insipidus: Farpresin may be given by injection or administered intranasally on cotton pledgets, by nasal spray, or by dropper. The dose by injection is 5 to 10 units (0.25 to 0.5 mL) repeated two or three times daily as needed. When Farpresin is administered intranasally by spray or on pledgets, the dosage and interval between treatments must be determined for each patient.
EMERGENCY MANAGEMENT OF ACUTE UPPER GASTROINTESTINAL BLEEDING: Has been administered by continuous intravenous infusion and by selective infusion via superior or inferior mesenteric artery. Because the intravenous route is relatively more convenient and accessible, it is generally recommended as the first choice.
A range dose regimens has been found to be effective. By the intravenous route, infusion with a concentration of 0.2 to 0.6 U/min. The initial infusion rate is then increased at 30 to 60 minute interval to 0.6 U/min or more if the bleeding is not controlled and the patient is tolerating the infusion. After bleeding is controlled, continue effective dose for 12 to 24 hours. Dose should then be gradually tapered over the next 24 to 48 hours.
Contraindications
Anaphylaxis or hypersensitivity to the drug or its components.
Special Precautions
General: Vasopressin should be used cautiously in the presence of epilepsy, migraine, asthma, heart failure, renal failure or any state in which a rapid addition to extracellular water may produce hazard for an already overburdened system.
Information for Patients: Side effects such as blanching of skin, abdominal cramps, and nausea may be reduced by taking 1 or 2 glasses of water at the time of vasopressin administration.
Laboratory Tests: Electrocardiograms (ECG) and fluid and electrolyte status determinations are recommended at periodic intervals during therapy.
This drug should not be used in patients with vascular disease, especially disease of the coronary arteries except with extreme caution.
In such patients, even small doses may precipitate anginal pain, and with larger doses, the possibility of myocardial infarction should be considered. Vasopressin may produced water intoxication.
The early signs of drowsiness, listlessness and headaches should be recognized, to prevent terminal coma and convultions.
Special care should be taken to avoid extravascular tissue infiltration at the infusion site. The intense vasoconstriction may lead to local necrosis and sloughing.
Use In Pregnancy & Lactation
Caution should be exercised when Vasopressin is administered to a nursing woman.
Vasopressin should be given to a pregnant woman only if clear needed.
Conventional supportive measures (eg. Blood transfusion, esophageal tamponade, paracentesis, nasogastric lavage) should accompany the use of vasopressin in such cases.
Adverse Reactions
Local or systemic allergic reactions may occur in hypersensitive individuals. The following side effects have been reported following the administration of vasopressin.
Body as a Whole: anaphylaxis (cardiac arrest and/or shock) has been observed shortly after injection of vasopressin.
Cardiovascular: cardiac arrest, circumoral pallor, arrhythmias, decreased cardiac output, angina, myocardial ischemia, peripheral vasoconstriction, and gangrene.
Gastrointestinal: abdominal cramps, nausea, vomiting, passage of gas.
Nervous System: tremor, vertigo, "pounding" in head.
Respiratory: bronchial constriction.
Skin and Appendages: sweating, urticaria, cutaneous gangrene.
Hypermotility, flatulence, peritonitis, pedal ischemia & subcutaneous infiltration and phlebitis at the infusion site.
The adverse effects of vasopressin are often the pharmacologic effects of the drug.
Severe water retention due to the antidiuretic activity of vasopressin has also been seen.
Catheter dislodgement, bleeding from the catheter site, hematoma at the catheter insertion site, bacteremia, ischemia and local gangrene have occurred in association with intraarterial catheterization.
Drug Interactions
The following drugs may potentiate the antidiuretic effect of vasopressin when used concurrently: carbamazepine; chlorpropamide; clofibrate; urea; fludrocortisone; tricyclic antidepressants.
The following drugs may decrease the antidiuretic effect of vasopressin when used concurrently: demeclocycline; norepinephrine; lithium; heparin; alcohol.
Ganglionic blocking agents may produce a marked increase in sensitivity to the pressor effects of vasopressin.
Storage
Store below 25°C.
ATC Classification
H01BA01 - vasopressin (argipressin) ; Belongs to the class of vasopressin and analogues. Used in posterior pituitary lobe hormone preparations.
Presentation/Packing
Inj (vial) 20 U/mL x 1 mL x 5's.
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