Pitressin (vasopressin injection, USP)

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Pitressin® (vasopressin injection, USP), Synthetic is a sterile, aqueous solution of synthetic vasopressin (8-Arginine vasopressin) of the posterior pituitary gland. It is substantially free from the oxytocic principle and is standardized to contain 20 pressor units/mL. The solution contains 0.5% Chlorobutanol (chloroform derivative) as a preservative. The acidity of the solution is adjusted with acetic acid.

Indications and Usage
Pitressin® is indicated for prevention and treatment of postoperative abdominal distention, in abdominal roentgenography to dispel interfering gas shadows, and in diabetes insipidus.

Contraindications
Anaphylaxis or hypersensitivity to the drug or its components.

Warnings
This drug should not be used in patients with vascular disease, especially disease of the coronary arteries, except with extreme caution. In such patients, even small doses may precipitate anginal pain, and with larger doses, the possibility of myocardial infarction should be considered. Vasopressin may produce water intoxication. The early signs of drowsiness, listlessness, and headaches should be recognized to prevent terminal coma and convulsions.

Adverse Reactions
Local or systemic allergic reactions may occur in hypersensitive individuals. The following side effects have been reported following the administration of vasopressin. Body as a Whole: anaphylaxis (cardiac arrest and/or shock) has been observed shortly after injection of vasopressin.

Cardiovascular: cardiac arrest, circumoral pallor, arrhythmias, decreased cardiac output, angina, myocardial ischemia, peripheral vasoconstriction, and gangrene.

Gastrointestinal: abdominal cramps, nausea, vomiting, passage of gas. Nervous System: tremor, vertigo, “pounding” in head.

Respiratory: bronchial constriction.

Skin and Appendages: sweating, urticaria, cutaneous gangrene.

Overdosage: Water intoxication may be treated with water restriction and temporary withdrawal of vasopressin until polyuria occurs. Severe water intoxication may require osmotic diuresis with mannitol, hypertonic dextrose, or urea alone or with furosemide.