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CardiovascularFDA Approved

Angiotensin II (Giapreza)

Overview

A synthetic form of the endogenous octapeptide angiotensin II, the primary effector of the renin-angiotensin system. Angiotensin II acts on AT1 receptors on vascular smooth muscle to produce potent vasoconstriction, and on the adrenal cortex to stimulate aldosterone release. Exogenous administration raises blood pressure in vasodilatory shock refractory to conventional vasopressors by restoring vascular tone through a mechanism complementary to catecholamine vasopressors.

Key Research Findings

FDA-approved in 2017 as a vasopressor for adults with septic or other distributory shock. ATHOS-3 trial demonstrated significant blood pressure improvement (MAP increase of 12.5 mmHg vs. placebo) in patients with catecholamine-resistant vasodilatory shock (Khanna et al., NEJM, 2017). Post-hoc analyses suggest particular benefit in patients with elevated renin and those on renal replacement therapy.

Route of Administration

Intravenous

Regulatory Status

FDA Approved

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