Miscellaneous urogenital disorders:
Indications for: TERLIVAZ
To improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function.
Limitations of Use:
Patients with a serum creatinine >5mg/dL are unlikely to experience benefit.
Give by slow IV bolus inj over 2mins. Initially 0.85mg (1 vial) every 6hrs on Days 1 to 3. On Day 4: if SCr decreased by ≥30% from baseline, continue 0.85mg (1 vial) every 6hrs; if decreased by <30% from baseline, increase to 1.7mg (2 vials) every 6hrs. For both, continue until 24hrs after patient achieves a second consecutive SCr value of ≤1.5mg/dL at least 2hrs apart or for a max of 14 days. If SCr is at or above baseline value, discontinue therapy.
Patients experiencing hypoxia or worsening respiratory symptoms. Patients with ongoing coronary, peripheral, or mesenteric ischemia.
Serious or fatal respiratory failure.
Risk of serious respiratory failure (may be fatal). Obtain baseline oxygen saturation; do not initiate in hypoxic patients. Assess Acute-on-Chronic Liver Failure (ACLF), volume status, and last available serum creatinine (SCr) prior to initiation. Monitor for changes in respiratory status; discontinue if hypoxia or increased respiratory symptoms occur. Increased risk of respiratory failure in those with fluid overload. Manage volume overload by reducing or discontinuing albumin and/or other fluids and use of diuretics. Temporarily interrupt, reduce, or discontinue therapy until volume status improves. Patients with ACLF Grade 3, a history of severe cardiovascular conditions, cerebrovascular and ischemic disease: avoid. Discontinue if signs/symptoms of ischemic adverse reactions occur. Ineligibility for liver transplantation possible due to terlipressin-related adverse reactions. Embryo-fetal toxicity. Pregnancy. Nursing mothers.
Abdominal pain, nausea, respiratory failure, diarrhea, dyspnea; ischemic events.
Generic Drug Availability: