PEPTIDESTAT
ApprovedClinical / approved drugIntravenousEvidence 4/5

Terlipressin

Also known as: Terlivaz, Glypressin

Terlipressin is a vasopressin V1 receptor agonist and prodrug for lysine-vasopressin that causes splanchnic vasoconstriction, lowering portal pressure and raising effective arterial volume and mean arterial pressure to improve renal perfusion.

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Terlipressin
Drug class
Synthetic vasopressin analog (V1 receptor agonist), prodrug of lysine-vasopressin
Primary targets
Vasopressin V1A receptor, Vasopressin V1B/V3 receptor, Vasopressin V2 receptor (lower affinity)
Dose reference
Reference label range (not a recommendation): Terlivaz 0.85 mg IV bolus every 6 hours (equal to 1 mg terlipressin acetate) for days 1-3, adjustable up to 1.7 mg every 6 hours, maximum 14 days
Half-life
Terlipressin terminal half-life about 0.9 hours; active metabolite lysine-vasopressin about 3.0 hours
Developer / origin
Mallinckrodt (US, Terlivaz); originally marketed in Europe as Glypressin (Ferring and others)
Reference year
2022
Evidence score
4/5 - Approved with pivotal RCT support; benefit is partial

Approved uses

  • Improving kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function (US, Terlivaz)
Evidence 4/5

Approved with pivotal RCT support; benefit is partial

Terlipressin is FDA approved as Terlivaz (2022) for improving kidney function in adults with hepatorenal syndrome, supported by the phase 3 CONFIRM RCT showing 32% verified HRS reversal vs 17% placebo, but with no mortality benefit and serious respiratory and ischemic risks carrying a boxed warning. It also has a long international evidence base for variceal bleeding.

Investigational compound with human randomized or phase 2/3 evidence.

Evidence basis

  • FDA Terlivaz approval (2022) and DailyMed prescribing information with boxed warning
  • CONFIRM phase 3 RCT (NCT02770716, NEJM 2021): 32% vs 17% verified HRS reversal, P=.006, no mortality benefit
  • Systematic review/meta-analysis of RCTs supporting terlipressin in acute variceal bleeding
  • Pharmacology reviews establishing V1 selectivity, prodrug mechanism and half-life

How to read this entry

Dose references and half-life values are pulled from trial protocols, labels, reviews, or published summaries where available. They are context for research and comparison, not a personal dosing recommendation.

Status matters: approved drugs have regulated indications; investigational compounds are still being studied; research-only peptides do not have established human dosing, safety, or efficacy for consumer use.

Terlipressin guides

Read the matching guide or adjacent research pages for more context.

Terlipressin Peptide: Terlivaz, Glypressin, Uses and Safety LimitsTerlipressin is a vasopressin analog prodrug, FDA approved as Terlivaz for hepatorenal syndrome, with strong vasoconstrictor evidence and serious respiratory and ischemic safety limits.Abaloparatide Peptide: Tymlos, PTHrP Analog Uses and Safety LimitsAbaloparatide is an FDA-approved PTHrP(1-34) analog peptide that builds bone in high-risk osteoporosis, backed by the ACTIVE and ATOM trials with clear duration and safety limits.Atosiban Peptide: Tractocile, Oxytocin Antagonist Tocolytic for Preterm LaborAtosiban is an EU-approved oxytocin and vasopressin receptor antagonist peptide used intravenously as a short-term tocolytic to delay preterm labor.Bivalirudin Peptide: Angiomax Direct Thrombin Inhibitor GuideBivalirudin is an FDA-approved, hirudin-derived bivalent direct thrombin inhibitor used as a short-acting intravenous anticoagulant during percutaneous coronary intervention.

Peptide calculators

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Peptide reconstitution calculatorCalculate concentration, draw volume and syringe units from vial strength and BAC water.Open toolPeptide accumulation calculatorModel repeated dosing schedules with half-life, interval, peak and trough estimates.Open toolPeptide unit converterConvert mg, mcg, optional IU and syringe units from one reconstituted vial setup.Open toolPeptide chemistry calculatorAnalyze sequence length, molecular weight, composition, charge, hydropathy and notation.Open tool

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Research & educational purposes only

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