Terlipressin: new recommendations to reduce risks of respiratory failure and septic shock in patients with type 1 hepatorenal syndrome

What this platform has drawn from it — 6 claims

• MHRA advises avoiding terlipressin in patients with advanced renal dysfunction, defined as a baseline serum creatinine at or above 442 micromol/L (5.0 mg/dL), unless the benefit is judged to outweigh the risks. Advice for healthcare professionals, third bullet, first nested sub-bullet · Advice for healthcare professionals, third bullet, parent clause
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• MHRA advises avoiding terlipressin in patients with severe liver disease, which it defines as acute-on-chronic liver failure grade 3, a Model for End-Stage Liver Disease score of 39 or more, or both, unless the benefit is judged to outweigh the risks. Advice for healthcare professionals, third bullet, second nested sub-bullet
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• MHRA advises stabilising patients with new-onset breathing difficulties, or worsening of existing respiratory disease, before administering terlipressin, and monitoring them closely during treatment. Advice for healthcare professionals, fourth bullet
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• MHRA advises considering a reduction in albumin dose in patients with signs or symptoms of respiratory failure or fluid overload, and discontinuing terlipressin if symptoms are severe or do not resolve. Advice for healthcare professionals, fifth bullet
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• MHRA advises monitoring patients receiving terlipressin daily for signs and symptoms of infection. Advice for healthcare professionals, sixth bullet
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• MHRA advises monitoring blood pressure, heart rate, oxygen saturation, serum sodium and potassium, and fluid balance during terlipressin treatment, noting that terlipressin may induce myocardial ischaemia and pulmonary vascular congestion, especially in those with pre-existing cardiopulmonary disease. Advice for healthcare professionals, seventh bullet
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