What Is Vasopressin Used For? Approved Uses, Per the Label
Vasopressin injection is a prescription medicine in the United States. Its approved US prescribing information lists one indication: increasing blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. Review articles describe vasopressin as a non-catecholamine vasopressor used alongside catecholamines in that setting. Other medicines acting on vasopressin receptors, including terlipressin and the vaptan antagonists, are separate products with their own labels. Questions about whether vasopressin applies to any individual situation belong with a prescribing clinician.
Answer first: what the label says vasopressin is used for
Vasopressin is a prescription medicine in the United States, supplied as a sterile solution for intravenous administration in hospital settings. The approved US prescribing information for vasopressin injection carries a single indication: to increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. That indication statement is the complete answer to the question of what the medicine is approved to be used for. Everything else discussed in the medical literature sits outside the indication section of the label.
This page is for educational purposes only and is not medical advice; consult a licensed physician or another qualified prescribing clinician about any question involving an individual patient, a hospital protocol, or a specific product. No administration directions, amounts, rates, or titration instructions appear anywhere on this page.
US label versions on DailyMed: Vasostrict (vasopressin) injection, DailyMed label version April 2026. The current label for the specific product governs.
Which product carries the indication
The approved indication belongs to vasopressin injection products, marketed under the brand name Vasostrict and, after subsequent approvals, as generic vasopressin injection and ready-to-use presentations from additional manufacturers. The current wording for any particular product appears in that product's own FDA-approved prescribing information, which is the controlling document for clinicians.
It is worth separating the hormone from the medicine. Arginine vasopressin is an endogenous nonapeptide that acts at V1a, V1b, and V2 receptors. A 2025 structural study published in Nature Communications (PMID 41188237) reported structural insights into how antagonists are recognised by the vasopressin V2 receptor, work that describes receptor pharmacology rather than any approved clinical indication. The approved product discussed on this page is the injectable vasopressor formulation, not the hormone as a biological concept.
Regulatory history of the indication
Vasopressin injection was used in United States hospitals for many years as a marketed product that had never gone through a formal new drug application. Under the Food and Drug Administration's initiative to bring long-marketed unapproved drugs into the approval system, a manufacturer submitted a full application and obtained approval for vasopressin injection with the vasodilatory shock indication. Approval of that application converted a long-standing hospital practice into a labelled indication with FDA-reviewed safety and efficacy language, pregnancy and pediatric sections, and standardised concentration information. Later approvals extended availability to additional manufacturers and to premixed, ready-to-use bottles and bags, each carrying the same indication framing.
Two consequences follow from that history. First, the indication was written around the way vasopressin was already being used in critical care, specifically as an addition to catecholamine therapy in adults who stayed hypotensive. Second, the randomised trial literature that informed clinical practice largely predates the approval, which is why the evidence base is most accessible today through review articles that collect and interpret those trials.
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Try it freeThe evidence base behind the indication: what reviews report
Vasopressin as a vasopressor in vasodilatory shock
A 2019 review in Critical Care Clinics titled "Vasopressin in Vasodilatory Shock" (PMID 30784607) examined the physiology and clinical use of vasopressin as a non-catecholamine vasopressor in vasodilatory shock states, the same clinical territory described in the approved indication. A broader 2019 review in Intensive Care Medicine on vasopressor therapy in critically ill patients with shock (PMID 31646370) covered how the available vasopressor agents, vasopressin among them, have been compared and positioned in critical care practice.
Readers looking for the pivotal randomised controlled trial reports themselves should note that those primary trial publications are not among the sources cited on this page, so no trial-level event rates, mortality figures, or comparative percentages are reproduced here. The reviews cited above are the sources used, and they are secondary literature that summarises the trial record rather than reporting new patient data.
Timing of initiation in septic shock
A 2023 narrative review in Chest titled "Optimizing Vasopressin Use and Initiation Timing in Septic Shock" (PMID 37479058) addressed when vasopressin has been added in septic shock and how initiation timing has been studied, a practice question that sits inside the labelled indication rather than outside it. The study was a narrative review, meaning the researchers synthesised published work rather than randomising patients, and such reviews describe practice variation instead of establishing a protocol. Decisions about timing in any individual patient are made by the treating critical care team.
Medicines related to vasopressin that carry their own separate labels
Several medicines act on vasopressin receptors or mimic vasopressin, and they are frequently confused with vasopressin injection. Each is a distinct product with its own indication wording, and none of them extends the vasopressin injection indication.
| Medicine | Relationship to vasopressin | What the cited literature covers |
|---|---|---|
| Terlipressin | Synthetic vasopressin analogue | A 2023 review in Expert Opinion on Pharmacotherapy (PMID 37535437) reviewed terlipressin in the management of liver disease. |
| Conivaptan | Vasopressin receptor antagonist | A review on conivaptan for the treatment of hyponatremia (PMID 30861683) and an earlier development profile (PMID 15816509) described its clinical development. |
| Vaptan class broadly | Vasopressin receptor antagonists | A 2015 review in Current Hypertension Reports (PMID 25604388) surveyed the vasopressin receptor antagonist class. |
| Agents used in hyponatremia management | Act downstream of vasopressin signalling | A 2010 review of hyponatremia treatment (PMID 20539224) and a 2023 review of hyponatremia in cancer (PMID 36831539) discussed the clinical context. |
The practical point is that vasopressin raising blood pressure in shock and a vaptan antagonist being used in hyponatremia are opposite pharmacological directions. The 2015 class review (PMID 25604388) reported on antagonists at vasopressin receptors, which are a different category of product from the vasopressor injection described by the approved indication on this page.
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Get the appUses that are not approved indications
One short factual note, kept separate from the indication so it is not mistaken for one. Published reports describe vasopressin being studied or administered in settings outside the approved adult vasodilatory shock indication, and those settings are not approved uses. A case series in the Journal of Perinatology (PMID 32951013) described vasopressin use in neonatal hypertrophic obstructive cardiomyopathy, a case series being the weakest tier of clinical evidence. Separately, a 2023 review of pharmacological treatment in autism (PMID 37714122) placed vasopressin-related agents among investigational approaches rather than approved therapies. Neither context appears in the approved indication statement.
Safety considerations in the vasopressin literature: What Studies Report
The approved prescribing information contains the authoritative warnings, precautions, contraindications, and adverse reaction tables for each vasopressin injection product, and that document is where clinicians look for safety specifics. In the peer-reviewed literature cited here, the 2019 Intensive Care Medicine review of vasopressor therapy in critically ill patients with shock (PMID 31646370) addressed how vasopressor agents are selected and monitored in shock, including safety considerations that influence agent choice. The 2019 Critical Care Clinics review (PMID 30784607) similarly discussed the clinical profile of vasopressin in vasodilatory shock, and the 2023 Chest narrative review (PMID 37479058) reported on how initiation decisions have been framed in septic shock. No specific adverse event rates are quoted here, because the sources cited are reviews rather than the primary safety datasets.
Because vasopressin injection is given intravenously to critically ill adults under continuous haemodynamic monitoring, its safety profile is managed by the treating team rather than by any individual outside that setting.
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Start learning freeWhere personal questions belong
Questions such as whether vasopressin applies to a particular patient, how it compares with another vasopressor for a specific case, or what a hospital protocol should say are clinical decisions. They belong with a prescribing clinician, an intensivist, or a hospital pharmacy and therapeutics committee, all of whom work from the current prescribing information and local protocols. This page summarises what the published literature and the indication framing state, and nothing on it substitutes for that conversation.
For a broader overview of the hormone, its receptors, and the research literature, see the PeptideU vasopressin overview.
References
- Vasopressor therapy in critically ill patients with shock (Intensive Care Medicine, 2019)
- Vasopressin in Vasodilatory Shock (Critical Care Clinics, 2019)
- Optimizing Vasopressin Use and Initiation Timing in Septic Shock: A Narrative Review (Chest, 2023)
- Terlipressin in the management of liver disease (Expert Opinion on Pharmacotherapy, 2023)
- Vasopressin receptor antagonists (Current Hypertension Reports, 2015)
- Conivaptan for the treatment of hyponatremia (Expert Review of Endocrinology & Metabolism, 2010)
- Conivaptan Yamanouchi (Current Opinion in Investigational Drugs, 2005)
- Treatment of hyponatremia (Current Opinion in Nephrology and Hypertension, 2010)
- Hyponatremia and Cancer: From Bedside to Benchside (Cancers, 2023)
- Structural insights into antagonist recognition by the vasopressin V2 receptor (Nature Communications, 2025)
- Use of vasopressin in neonatal hypertrophic obstructive cardiomyopathy: case series (Journal of Perinatology, 2021)
- Autism. Pharmacological treatment (Medicina, 2023)
Frequently asked questions
What is vasopressin approved for in the United States?▾
The US prescribing information for vasopressin injection lists one indication: increasing blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. Review articles describe that same clinical territory, including a 2019 Critical Care Clinics review of vasopressin in vasodilatory shock (PMID 30784607). The product label is the controlling document for any clinical question.
Is vasopressin approved for treating hyponatremia?▾
No. Hyponatremia is addressed by a different pharmacological class, the vasopressin receptor antagonists, which are separate approved products with their own labels. A 2015 class review surveyed those antagonists (PMID 25604388), a review covered conivaptan for hyponatremia (PMID 30861683), and a 2010 review discussed hyponatremia treatment broadly (PMID 20539224).
Is terlipressin the same medicine as vasopressin?▾
No. Terlipressin is a synthetic vasopressin analogue approved and studied in its own right, with indication wording distinct from vasopressin injection. A 2023 review in Expert Opinion on Pharmacotherapy examined terlipressin in the management of liver disease (PMID 37535437). Questions about which agent fits a given clinical situation are answered by the treating physician, not by comparing labels informally.
What does the literature report about when vasopressin is started in septic shock?▾
A 2023 narrative review in Chest examined vasopressin use and initiation timing in septic shock and reported on how timing has been studied and how practice varies (PMID 37479058). Because it was a narrative review, researchers synthesised existing publications rather than randomising patients. Timing decisions for an individual patient remain with the critical care team managing that patient.
Has vasopressin been described outside its approved indication?▾
Yes, and those contexts are not approved uses. A case series in the Journal of Perinatology described vasopressin in neonatal hypertrophic obstructive cardiomyopathy (PMID 32951013), and a 2023 review placed vasopressin-related agents among investigational approaches in autism pharmacology (PMID 37714122). Neither appears in the approved indication statement for vasopressin injection.
How did vasopressin injection obtain an approved indication?▾
Vasopressin was used in US hospitals for decades as a marketed product without a formal approval, then a manufacturer submitted a full application under the FDA initiative covering long-marketed unapproved drugs, producing the vasodilatory shock indication. Later approvals added other manufacturers and ready-to-use presentations. Review articles such as a 2019 vasopressor therapy review describe the clinical practice context (PMID 31646370).
Where can the official indication wording be found?▾
The FDA-approved prescribing information for each specific vasopressin injection product contains the current indication, warnings, and adverse reaction sections, and labels are revised periodically. Peer-reviewed reviews such as the 2019 Critical Care Clinics article on vasopressin in vasodilatory shock (PMID 30784607) summarise clinical evidence but do not replace label text. A prescribing clinician or hospital pharmacist can supply the current document.
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References
This page summarises published research for education — it is not medical advice, and nothing here is a recommendation to use, purchase, or dose any substance. Study parameters described are what researchers reported, not instructions. Consult a qualified clinician before any health decision.