Daily Medication Pearl: Angiotensin II (Giapreza) Injection

Medication Pearl of the Day: Angiotensin II (Giapreza) Injection

Indication: Angiotensin II (Giapreza) is a vasoconstrictor to increase blood pressure in adults with septic or other distributive shock.

Insight:

• Dosing: Start angiotensin II intravenously at 20 nanograms (ng)/kg/min. Titrate as frequently as every 5 minutes by increments of up to 15 ng/kg/min as needed. During the first 3 hours, the maximum dose should not exceed 80 ng/kg/min. Maintenance dose should not exceed 40 ng/kg/min.
• Dosage forms: Injection 2.5 mg/mL and 5 mg/2 mL (2.5 mg/mL) in a vial.
• Adverse events: The most common adverse reactions reported in greater than 10% in patients administered angiotensin II were thromboembolic events.
• Mechanism of action: Angiotensin II raises blood pressure by vasoconstriction and increased aldosterone release. Direct action of angiotensin II on the vessel wall is mediated by binding to the G-protein-coupled angiotensin II receptor type 1 on vascular smooth muscle cells, which stimulates Ca2+/calmodulin-dependent phosphorylation of myosin and causes smooth muscle contraction.

Source: LABEL (fda.gov)