Vpress

Antidiuretic hormone, also known as Vpress, is a nine amino acid peptide secreted from the posterior pituitary. Antidiuretic hormone binds to receptors in the distal or collecting tubules of the kidney and promotes reabsorbtion of water back into the circulation

Vpress Injection, USP is indicated for prevention and treatment of postoperative abdominal distention, in abdominal roentgenography to dispel interfering gas shadows and in diabetes insipidus.

Vpress is a man-made form of a hormone called "anti-diuretic hormone" that is normally secreted by the pituitary gland. In the body, Vpress acts on the kidneys and blood vessels.

Vpress helps prevent the loss of water from the body by reducing urine output and helping the kidneys reabsorb water in the body. Vpress also raises blood pressure by constricting (narrowing) blood vessels.

Vpress is used to treat diabetes insipidus, which is caused by a lack of this naturally occurring pituitary hormone in the body. Vpress is also used to treat or prevent certain conditions of the stomach after surgery or during abdominal x-rays.

Vpress may also be used for purposes other than those listed in this medication guide.

Vpress may be administered subcutaneously or intramuscularly.

Ten units of Vpress (0.5 mL) will usually elicit full physiologic response in adult patients; 5 units will be adequate in many cases. Vpress 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 below.)

When determining the dose of Vpress 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 Vpress 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. It is recommended that Vpress be given intramuscularly and that injections be repeated at 3- or 4-hour intervals as required. Dosage to be reduced proportionately for pediatric patients.

Vpress 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, respectively, before films are exposed. Many roentgenologists advise giving an enema prior to the first dose of Vpress.

Diabetes Insipidus

Vpress 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 Vpress is administered intranasally by spray or on pledgets, the dosage and interval between treatments must be determined for each patient.

How supplied

Vpress (Vpress Injection, USP) Synthetic is supplied in vials as follows:

NDC 42023-117-25

1 mL vial (20 USP units). Packages of 25 vials.

Store between 20° to 25°C (68° to 77°F).

Manufactured and Distributed by: JHP Pharmaceuticals, LLC, Rochester, MI 48307. Revised: Oct 2012.

See also:
What is the most important information I should know about Vpress?

You should not receive this medication if you have a chronic kidney condition such as Bright's disease.

Before receiving Vpress, tell your doctor if you are allergic to any drugs, or if you have asthma, kidney disease, congestive heart failure, hardened arteries, migraine headaches, or seizures.

Some people receiving Vpress have had an immediate reaction to the medication. Tell your caregiver right away if you feel weak, nauseated, light-headed, sweaty, or have a fast heartbeat, chest tightness, or weak breathing just after receiving Vpress.

Vpress can cause temporary side effects such as nausea, stomach pain, or "blanching" of your skin (such as pale spots when you press on the skin). Drinking 1 or 2 glasses of water each time you receive an injection may help ease these side effects.

Follow your doctor's instructions about the type and amount of liquids you should drink during your treatment with Vpress. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Use Vpress as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Vpress is given as an infusion at your doctor's office, hospital, or clinic. Contact your health care provider if you have any questions.
• If you miss a dose of Vpress, contact your doctor right away.

Ask your health care provider any questions you may have about how to use Vpress.

Use: Labeled Indications

Shock, vasodilatory: To increase blood pressure in adults with vasodilatory shock (eg, postcardiotomy or sepsis) who remain hypotensive despite fluid resuscitation and catecholamines.

Off Label Uses

Cadaveric organ recovery (hormone replacement therapy)

Data from four consecutive retrospective cohort studies of brain-dead donors who successfully donated organs suggests that the use of intravenous Vpress given concomitantly with levothyroxine, methylprednisolone, and a continuous infusion of insulin (goal blood glucose: 120 to 180 mg/dL) may be beneficial for hemodynamically unstable brain-dead donors to increase the quantity and quality of organs available for transplantation.

See also:
What other drugs will affect Vpress?

Catecholamines

Use with catecholamines is expected to result in an additive effect on mean arterial blood pressure and other hemodynamic parameters.

Indomethacin

Use with indomethacin may prolong the effect of Vpress on cardiac index and systemic vascular resistance.

Ganglionic Blocking Agents

Use with ganglionic blocking agents may increase the effect of Vpress on mean arterial blood pressure.

Furosemide

Use with furosemide increases the effect of Vpress on osmolar clearance and urine flow.

Drugs Suspected Of Causing SIADH

Use with drugs suspected of causing SIADH (e.g., SSRIs, tricyclic antidepressants, haloperidol, chlorpropamide, enalapril, methyldopa, pentamidine, vincristine, cyclophosphamide, ifosfamide, felbamate) may increase the pressor effect in addition to the antidiuretic effect of Vpress.

Drugs Suspected Of Causing Diabetes Insipidus

Use with drugs suspected of causing diabetes insipidus (e.g., demeclocycline, lithium, foscarnet, clozapine) may decrease the pressor effect in addition to the antidiuretic effect of Vpress.

See also:
What are the possible side effects of Vpress?

Applies to Vpress: injection solution

As well as its needed effects, Vpress (the active ingredient contained in Vpress) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking Vpress, check with your doctor immediately:

Incidence not known:

• Abdominal or stomach pain, usually after eating a meal
• agitation
• back pain
• chest pain or discomfort
• chest tightness or heaviness
• coma
• confusion
• constipation
• convulsions
• cough
• decreased urine output
• depression
• diarrhea
• difficulty with swallowing
• dilated neck veins
• dizziness
• extreme fatigue
• fainting
• fast or irregular heartbeat
• headache
• hives, itching, or rash
• hostility
• increased thirst
• irregular breathing
• irritability
• lethargy
• lightheadedness, dizziness, or fainting
• muscle pain or cramps
• muscle twitching
• nausea or vomiting
• no blood pressure or pulse
• pain in the shoulders, arms, jaw, or neck
• pale, cool, or blotchy skin on the arms or legs
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid weight gain
• seizures
• slow or irregular heartbeat
• stopping of heart
• stupor
• sweating
• swelling of the face, ankles, fingers, feet, or lower legs
• troubled breathing
• unconsciousness
• unusual tiredness or weakness
• weak or absent pulse in the arms or legs

Minor Side Effects

Some Vpress side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Incidence not known:

• Abdominal or stomach cramps
• feeling of constant movement of self or surroundings
• pale skin
• passing of gas
• pounding in the head
• sensation of spinning
• shakiness in the legs, arms, hands, or feet
• sweating
• trembling or shaking of the hands or feet