Vasopressin (ADH)
Overview
A nine-amino acid cyclic peptide hormone (arginine vasopressin) produced in the hypothalamus and released from the posterior pituitary. Vasopressin acts on V1a receptors (vascular smooth muscle vasoconstriction), V1b receptors (ACTH release from pituitary), and V2 receptors (aquaporin-2 insertion in renal collecting ducts for water reabsorption). It is essential for body water homeostasis and hemodynamic stability.
Key Research Findings
FDA-approved for diabetes insipidus, prevention and treatment of postoperative abdominal distention, and as a vasopressor in vasodilatory shock. VASST trial evaluated vasopressin vs. norepinephrine in septic shock with inconclusive primary outcome but benefit in less severe sepsis subgroup (Russell et al., NEJM, 2008). Recommended in ACLS guidelines as an alternative to epinephrine in cardiac arrest.
Intravenous, Intramuscular injection, Subcutaneous injection
FDA Approved
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Find a Vasopressin (ADH) ProviderRelated Peptides
Desmopressin (DDAVP)
FDA ApprovedA synthetic analog of vasopressin with enhanced V2 receptor selectivity and minimal V1a vasopressor activity. Desmopressin has a deaminated cysteine at position 1 and D-arginine at position 8, increasing its antidiuretic potency 10-fold while largely eliminating the hypertensive effects of native vasopressin. Its prolonged half-life of 2-4 hours (vs. 10-20 minutes for vasopressin) allows convenient dosing for chronic conditions.
Terlipressin
FDA ApprovedA synthetic vasopressin analog and prodrug that is cleaved by endopeptidases to release lysine-vasopressin. Terlipressin has greater V1a receptor selectivity than vasopressin, producing splanchnic vasoconstriction that reduces portal pressure and redistributes blood flow to the kidneys. This mechanism addresses the pathophysiology of hepatorenal syndrome (HRS) by counteracting the splanchnic vasodilation that drives renal hypoperfusion.