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Renal · FDA Approved

Terlipressin

FDA-approved

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

01 · Overview

A synthetic vasopressin analog and prodrug that is converted in the body to lysine-vasopressin.

Terlipressin acts mainly on V1 receptors to constrict splanchnic blood vessels, counteracting the splanchnic vasodilation and renal hypoperfusion that drive hepatorenal syndrome (HRS) in advanced cirrhosis (PMID 34606933) (PMID 37625864).

02 · Research summary & key findings

FDA-approved in September 2022 (Terlivaz) for hepatorenal syndrome (PMID 37625864). In the phase 3 CONFIRM trial, verified HRS reversal occurred in 32% of patients on terlipressin plus albumin vs. 17% on placebo (Wong et al., NEJM, 2021) (PMID 33657294). Terlipressin had already been used as a first-line HRS therapy in much of Europe (PMID 34606933). CONFIRM also found more respiratory failure, with respiratory deaths within 90 days in 11% vs. 2% (PMID 33657294). The US label carries a boxed warning for serious or fatal respiratory failure and advises against starting treatment in patients with hypoxia; early US experience found better response and fewer discontinuations when these labeling criteria were followed (PMID 42107856).

03 · Regulatory status

Terlipressin has received FDA approval and is available for clinical use under appropriate medical supervision. Consult a qualified healthcare provider for prescribing information.

Terlipressin 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]Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome N Engl J Med, 2021. PMID 33657294
  2. [2]Terlipressin and the Treatment of Hepatorenal Syndrome: How the CONFIRM Trial Moves the Story Forward Am J Kidney Dis, 2022. PMID 34606933
  3. [3]Current Pharmacologic Therapies for Hepatorenal Syndrome-Acute Kidney Injury Clin Gastroenterol Hepatol, 2023. PMID 37625864
  4. [4]United States Experience With Terlipressin in Hepatorenal Syndrome: Response, Mortality, and Transplant Outcomes - Results From the HRS Harmony Consortium Clin Gastroenterol Hepatol, 2026. PMID 42107856

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.