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EMA-approvedaka Argipressin, ADH, Pitressin, Vasostrict

Vasopressin — Complete Research Guide (2026)

Last updated 2026-06-30

TL;DR

Vasopressin (also known as Argipressin) is a peptide catalogued under Sexual Health (Neurohypophyseal hormone). It is described as: V1a/V1b/V2 receptor. Documented context: Diabetes insipidus; vasodilatory shock. Neutral reference entry; EU status: EU-approved prescription medicine.

What is Vasopressin?

Vasopressin (arginine vasopressin, AVP; also called antidiuretic hormone) is a nine-amino-acid posterior-pituitary peptide hormone marketed as a prescription injectable (for example Vasostrict). It is FDA-approved to raise blood pressure in adults with vasodilatory (septic or post-cardiotomy) shock who remain hypotensive despite fluids and catecholamine vasopressors.

Evidence is from human randomized trials in the intensive-care setting: it is an established adjunct vasopressor rather than an experimental agent.

It is also used, on the basis of guideline and trial evidence, for post-cardiac-surgery vasoplegia and as an option in cardiac arrest, though it is no longer part of routine ACLS algorithms.

How does Vasopressin work?

Vasopressin causes vasoconstriction chiefly through V1a receptors on vascular smooth muscle, restoring vascular tone independently of the adrenergic (catecholamine) pathway.

It also acts on renal V2 receptors to promote water reabsorption (antidiuresis).

What does the research say about Vasopressin?

  • In septic shock, adding vasopressin to norepinephrine did not lower 28-day mortality overall versus norepinephrine alone, but appeared to benefit patients with less-severe shock in a large randomized trial (VASST). [1]
  • As first-line vasopressor in vasoplegic shock after cardiac surgery, vasopressin reduced a composite of death and severe complications compared with norepinephrine in a randomized trial (VANCS). [3]
  • Adding vasopressin to catecholamine vasopressors in distributive shock was associated with a lower risk of atrial fibrillation in a systematic review and meta-analysis. [5]

Clinical research & studies

The references below are the primary sources cited throughout this guide. Each links directly to PubMed or the regulator. Where evidence is preclinical (animal or in-vitro), that is stated rather than implied.

  • [1] Vasopressin versus norepinephrine infusion in patients with septic shock — Russell JA et al., New England Journal of Medicine 2008. (Randomized controlled trial (VASST))
  • [2] Effect of Early Vasopressin vs Norepinephrine on Kidney Failure in Patients With Septic Shock: The VANISH Randomized Clinical Trial — Gordon AC et al., JAMA 2016. (Randomized controlled trial (VANISH))
  • [3] Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The VANCS Randomized Controlled Trial — Hajjar LA et al., Anesthesiology 2017. (Randomized controlled trial (VANCS))
  • [4] A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation — Wenzel V et al., New England Journal of Medicine 2004. (Randomized controlled trial)
  • [5] Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis — McIntyre WF et al., JAMA 2018. (Systematic review and meta-analysis)

Dosing context

This is not medical advice or a usage recommendation. Dosing figures are reported research context only, cited from the published literature.

Vasopressin is administered only as a continuous intravenous infusion by critical-care teams, usually at low fixed doses (commonly around 0.03 units/min in septic shock) added to catecholamines, with hemodynamic and organ-perfusion monitoring.

This is context only, not a dosing guide: doses, indications and weaning are individualized by intensivists in a hospital ICU, and abrupt withdrawal can cause rebound hypotension.

Side effects & safety profile

The dominant risks are ischaemia from intense vasoconstriction: digital, mesenteric (gut), cardiac and skin ischaemia, plus bradycardia and reduced cardiac output.

It must be given by trained clinicians in a monitored ICU or critical-care setting with careful titration and typically a continuous norepinephrine background.

In the VANISH trial, early vasopressin did not reduce kidney failure versus norepinephrine in septic shock, underscoring that it is a blood-pressure-support agent, not a proven organ-protective one; it should not be used as a stand-alone resuscitation drug outside its approved indications.

Stacking & combinations

In practice it is combined with catecholamine vasopressors such as norepinephrine as a second-line agent under intensive-care supervision, not combined with unproven supplements or research peptides.

Finding Vasopressin vendors

Finding Vasopressin vendors

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Frequently asked questions

Yes. Vasopressin injection is FDA-approved to raise blood pressure in adults with vasodilatory shock (such as septic or post-cardiotomy shock) who stay hypotensive despite fluids and catecholamine vasopressors.

References

  1. [1] Vasopressin versus norepinephrine infusion in patients with septic shock — Russell JA et al., New England Journal of Medicine 2008. PMID: 18305265. View sourceStudy: Randomized controlled trial (VASST)Low-dose vasopressin added to norepinephrine did not reduce 28-day mortality overall but suggested benefit in less-severe septic shock.
  2. [2] Effect of Early Vasopressin vs Norepinephrine on Kidney Failure in Patients With Septic Shock: The VANISH Randomized Clinical Trial — Gordon AC et al., JAMA 2016. PMID: 27483065. View sourceStudy: Randomized controlled trial (VANISH)Early vasopressin versus norepinephrine did not significantly reduce the number of kidney-failure-free days in septic shock.
  3. [3] Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The VANCS Randomized Controlled Trial — Hajjar LA et al., Anesthesiology 2017. PMID: 27841822. View sourceStudy: Randomized controlled trial (VANCS)Vasopressin as first-line vasopressor lowered a composite of mortality and severe complications versus norepinephrine after cardiac surgery.
  4. [4] A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation — Wenzel V et al., New England Journal of Medicine 2004. PMID: 14711909. View sourceStudy: Randomized controlled trialVasopressin and epinephrine gave similar overall survival in out-of-hospital cardiac arrest, with a possible advantage in asystole.
  5. [5] Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis — McIntyre WF et al., JAMA 2018. PMID: 29801010. View sourceStudy: Systematic review and meta-analysisAdding vasopressin to catecholamines in distributive shock was associated with lower risk of atrial fibrillation and reduced catecholamine requirements.
This article is for educational and research purposes only. Peptides discussed here are not approved for human consumption by the FDA, EMA, or equivalent regulators outside of specific clinical contexts. Always consult a licensed medical professional before any therapeutic use.