Classifications: hormone; pituitary, antidiuretic hormone (adh);
Therapeutic: adh replacement

Pregnancy Category: C


20 pressor units/mL injection


Polypeptide hormone extracted from animal posterior pituitaries. Possesses pressor and antidiuretic (ADH) properties, but is relatively free of oxytocic properties. Produces concentrated urine by increasing tubular reabsorption of water (ADH activity), thus reabsorbing up to 90% of water in the renal tubules.

Therapeutic Effect

Effective in reversing diuresis caused by diabetes insipidus.


Antidiuretic to treat diabetes insipidus, to dispel gas shadows in abdominal roentgenography, and as prevention and treatment of postoperative abdominal distension. Also given to treat transient polyuria due to ADH deficiency (related to head injuries or to neurosurgery).

Unlabeled Uses

Test for differential diagnosis of nephrogenic, psychogenic, and neurohypophyseal diabetes insipidus; test to elevate ability of kidney to concentrate urine, and provocative test for pituitary release of corticotropin and growth hormone; emergency and adjunct pressor agent in the control of massive GI hemorrhage (e.g., esophageal varices).


Chronic nephritis accompanied by nitrogen retention; ischemic heart disease, PVCs, advanced arteriosclerosis; pregnancy (category C); during first stage of labor; lactation.

Cautious Use

Epilepsy; migraine; asthma; heart failure, angina pectoris; any state in which rapid addition to extracellular fluid may be hazardous; vascular disease; preoperative and postoperative polyuric patients, kidney disease; goiter with cardiac complications; older adult patients, children.

Route & Dosage

Diabetes Insipidus
Adult: IM/SC 5–10 U aqueous solution 2–4 times/d (5–60 U/d) or 1.25–2.5 U in oil q2–3d  Intranasal Apply to cotton pledget or intranasal spray
Child: IM/SC 2.5–10 U aqueous solution 2–4 times/d

Abdominal Distention, Abdominal Radiographic Procedures
Adult: IM/SC 5 U with 5–10 U q3–4h prn or 5–15 U 2 h and 30 min prior to procedure

GI Hemorrhage
Adult: IV 0.2–0.4 U/min up to 0.9 U/min


  • Give 1–2 glasses of water with vasopressin to reduce adverse effects of tannate and improve therapeutic response.
  • Do NOT administer vasopressin tannate via IV. Warm ampule to body temperature and shake vigorously to disperse active principle before withdrawing drug for IM administration.
  • The tannate injection is often painful, and allergic reactions may develop. It is preferred for use in chronic therapy because of its longer duration of action.

PREPARE: Direct/IV Infusion: Dilute with NS or D5W to a concentration of 0.1–1 U/mL.  

ADMINISTER: Direct: Give rapid bolus dose.  IV Infusion: Titrate dose and rate to patient's response. ??Ensure patency prior to injection or infusion as extravasation may cause severe vasoconstriction with tissue necrosis and gangrene. 

Adverse Effects (≥1%)

Skin: Rash, urticaria. Body as a Whole: Anaphylaxis; tremor, sweating, bronchoconstriction, circumoral and facial pallor, angioneurotic edema, pounding in head, water intoxication (especially with tannate), gangrene at injection site with intraarterial infusion. GI: Eructations, passage of gas, nausea, vomiting, heartburn, abdominal cramps, increased bowel movements secondary to excessive use. CV: Angina (in patient with coronary vascular disease); cardiac arrest, hypertension, bradycardia, minor arrhythmias, premature atrial contraction, heart block, peripheral vascular collapse, coronary insufficiency, MI; cardiac arrhythmia, pulmonary edema, bradycardia (with intraarterial infusion). Urogenital: Uterine cramps. Respiratory: Congestion, rhinorrhea, irritation, mucosal ulceration and pruritus, postnasal drip. Special Senses: Conjunctivitis.

Diagnostic Test Interference

Vasopressin increases plasma cortisol levels.


Drug: Alcohol, demeclocycline, epinephrine, heparin, lithium, phenytoin may decrease antidiuretic effects of vasopressin; guanethidine, neostigmine increase vasopressor actions; chlorpropamide, clofibrate, carbamazepine, thiazide diuretics may increase antidiuretic activity.


Duration: 2–8 h in aqueous solution, 48–72 h in oil, 30–60 min IV infusion. Distribution: Extracellular fluid. Metabolism: In liver and kidneys. Elimination: In urine. Half-Life: 10–20 min.

Nursing Implications

Assessment & Drug Effects

  • Monitor infants and children closely. They are more susceptible to volume disturbances (such as sudden reversal of polyuria) than adults.
  • Establish baseline data of BP, weight, I&O pattern and ratio. Monitor BP and weight throughout therapy. (Dose used to stimulate diuresis has little effect on BP.) Report sudden changes in pattern to physician.
  • Be alert to the fact that even small doses of vasopressin may precipitate MI or coronary insufficiency, especially in older adult patients. Keep emergency equipment and drugs (antiarrhythmics) readily available.
  • Check patient's alertness and orientation frequently during therapy. Lethargy and confusion associated with headache may signal onset of water intoxication, which, although insidious in rate of development, can lead to convulsions and terminal coma.
  • Monitor urine output, specific gravity, and serum osmolality while patient is hospitalized.
  • Withhold vasopressin, restrict fluid intake, and notify physician if urine-specific gravity is <1.015.

Patient & Family Education

  • Be prepared for possibility of anginal attack and have coronary vasodilator available (e.g., nitroglycerin) if there is a history of coronary artery disease. Report to physician.
  • Measure and record data related to polydipsia and polyuria. Learn how to determine specific gravity and how to keep an accurate record of output. Understand that treatment should diminish intense thirst and restore undisturbed normal sleep.
  • Avoid concentrated fluids (e.g., undiluted syrups), since these increase urine volume.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

© 2006-2023 Last Updated On: 02/02/2023 (0)
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