Angiotensin II
Also known as: Ang II, Angiotensin II, angiotensin-2, ATII, Giapreza, human angiotensin II, LY163502
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Summary
Synthetic human angiotensin II (Giapreza) is an 8‑amino‑acid peptide used intravenously to raise blood pressure in adults with septic or other distributive shock refractory to catecholamines.
Mechanism of Action
Activates AT1 (and AT2) receptors leading to vasoconstriction, aldosterone secretion, and increased systemic vascular resistance.
Routes of Administration
Goals & Uses
- Hepatorenal Syndrome (investigational)Renal/HepaticLow
- Mean Arterial Pressure IncreaseHemodynamic SupportHigh
- Septic Shock Rescue TherapyCritical CareHigh
- Increase mean arterial pressureHemodynamic SupportHigh
- Catecholamine-Sparing EffectSupportive CareModerate
- Vasodilatory/Distributive Shock ManagementHemodynamic SupportHigh
Contraindications
- Hypersensitivity to angiotensin II or excipientsAllergyHigh
- Concurrent use of ACE inhibitors in certain contextsDrug InteractionModerate
- Hypersensitivity to the drug productImmunologicHigh
- Active myocardial ischemiaCardiovascularHigh
Adverse Effects
- HypertensionCardiovascularCommonHigh blood pressure
- Peripheral ischemiaVascularUncommon
- Thromboembolic eventsCardiovascularUncommon
- Digital ischemiaPeripheral VascularRare
- Fungal infectionInfectiousUncommon
- TachycardiaCardiovascularCommonAbnormally fast heart rate
- Thromboembolic events (DVT, arterial thrombosis)CardiovascularCommon
- Delirium / agitationNeuropsychiatricUncommon
- Hypertension / excessive blood pressure elevationCardiovascularCommon
Drug Interactions
- Norepinephrine / CatecholaminesModerate
- Angiotensin Receptor Blockers (ARBs)Moderate
- ARBs (angiotensin receptor blockers)High
- VasopressinModerate
- ACE inhibitorsModerate
- ACE Inhibitors (e.g., enalapril, lisinopril)Moderate
Population Constraints
- PregnancyReproductive SafetyRelative
- Pediatric patientsAgeRelative
- Patients with pre-existing thromboembolic disordersHematologicRelative
- Pregnant womenReproductiveRelative
- Severe coronary artery diseaseCardiovascularRelative
Regulatory Status
- European UnionUnapprovedNo marketing authorization as of 2024.
- United StatesApprovedApproved: Vasodilatory shock refractory to catecholaminesApproved under FDA label as Giapreza.
- United KingdomApprovedApproved: Vasodilatory shock in adultsApproved by MHRA following EMA approval; post-Brexit maintained authorization.
FDA‑approved (2017) for vasodilatory shock; marketed as Giapreza. Not approved in the EU as of 2024.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Angiotensin II?
Synthetic human angiotensin II (Giapreza) is an 8‑amino‑acid peptide used intravenously to raise blood pressure in adults with septic or other distributive shock refractory to catecholamines.
What is Angiotensin II used for?
Angiotensin II is educationally associated with: Hepatorenal Syndrome (investigational), Mean Arterial Pressure Increase, Septic Shock Rescue Therapy, Increase mean arterial pressure, Catecholamine-Sparing Effect, Vasodilatory/Distributive Shock Management. Educational only — not medical advice.
How is Angiotensin II administered?
Recorded routes of administration: Intravenous.
What are the potential side effects of Angiotensin II?
Reported adverse effects include: Hypertension, Peripheral ischemia, Thromboembolic events, Digital ischemia, Fungal infection, Tachycardia, Thromboembolic events (DVT, arterial thrombosis), Delirium / agitation, Hypertension / excessive blood pressure elevation. This list is not exhaustive — consult a qualified clinician.
Who should avoid Angiotensin II?
Recorded contraindications: Hypersensitivity to angiotensin II or excipients, Concurrent use of ACE inhibitors in certain contexts, Hypersensitivity to the drug product, Active myocardial ischemia. Consult a qualified clinician before use.