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Cardiovascular · FDA Approved

Angiotensin II (Giapreza)

FDA-approved

How to ask your doctor
Written by Peptide Association Editorial TeamLast reviewed Editorial policy

01 · Overview

A synthetic form of the endogenous octapeptide angiotensin II, the main effector of the renin-angiotensin system. Angiotensin II acts on AT1 receptors on vascular smooth muscle to cause vasoconstriction and on the adrenal cortex to stimulate aldosterone release.

Given intravenously, it raises blood pressure in vasodilatory shock that does not respond to high doses of conventional vasopressors (PMID 28528561).

02 · Research summary & key findings

FDA-approved in 2017 (Giapreza) to raise blood pressure in adults with septic or other distributive shock. In the ATHOS-3 trial, the blood pressure response target at hour 3 was reached by 69.9% of patients on angiotensin II vs. 23.4% on placebo; 28-day mortality was 46% vs. 54%, a difference that was not statistically significant (Khanna et al., NEJM, 2017) (PMID 28528561). Post hoc analyses suggested greater benefit in patients with high baseline renin levels (PMID 32609011) and in those receiving renal replacement therapy (PMID 29509568).

03 · Regulatory status

Angiotensin II (Giapreza) has received FDA approval and is available for clinical use under appropriate medical supervision. Consult a qualified healthcare provider for prescribing information.

Angiotensin II (Giapreza) is an FDA-approved medicine prescribed for the conditions on its label. It is not part of our intake, so we do not propose protocols for it. If you think it may be relevant to you, talk to your own doctor. How to ask your doctor.

04 · Administration routes

  • Intravenous

References

  1. [1]Angiotensin II for the Treatment of Vasodilatory Shock N Engl J Med, 2017. PMID 28528561
  2. [2]Outcomes in Patients with Vasodilatory Shock and Renal Replacement Therapy Treated with Intravenous Angiotensin II Crit Care Med, 2018. PMID 29509568
  3. [3]Renin and Survival in Patients Given Angiotensin II for Catecholamine-Resistant Vasodilatory Shock. A Clinical Trial Am J Respir Crit Care Med, 2020. PMID 32609011

Primary literature

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Disclaimer: This information is provided for educational and research purposes only. It is not intended as medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any peptide therapy. The Peptide Association does not endorse or recommend any specific treatment protocol. See our editorial policy for how this content is produced and reviewed. Clinicians: join the network.