Selepressin
Also known as: [Phe2,Ile3,Hom(Cys)6]-oxytocin, FE 202158, FE‑202158, FE202158, Selepressin acetate, V1a‑selective vasopressin analog
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Summary
Selepressin (FE‑202158) is a synthetic peptide analog of vasopressin with high affinity for V1a receptors. It has been studied intravenously for the treatment of septic shock to improve hemodynamics and reduce the need for other vasopressors. Development has not resulted in regulatory approval.
Mechanism of Action
Selective activation of vasopressin V1a receptors causing peripheral vasoconstriction and reduction of catecholamine requirements in septic shock
Routes of Administration
Goals & Uses
- Reduction of norepinephrine requirementsCatecholamine SparingModerate
- Avoidance of V2-mediated adverse effectsSafety Improvement Over VasopressinModerate
- Treatment of vasodilatory/septic shockHemodynamic SupportModerate
- Restoration of vascular tone in distributive shockHemodynamic SupportLow
- Septic shock managementCritical CareModerate
Contraindications
- Known hypersensitivity to selepressin or its excipientsAllergyHigh
- Hypersensitivity to selepressin or vasopressin analoguesAllergyHigh
- Cardiogenic shockCardiovascularHigh
- Severe coronary artery disease or recent myocardial infarctionCardiovascularModerate
- Severe peripheral vascular diseaseVascularHigh
Adverse Effects
- HypertensionCardiovascularCommonHigh blood pressure
- Reduced cardiac outputCardiovascularUncommon
- Digital/mesenteric ischemiaVascularUncommon
- Peripheral ischemia (e.g., mesenteric, digital)VascularUncommon
- HyponatremiaElectrolyteRare
- Skin necrosis at infusion siteDermatologicalRare
- BradycardiaCardiovascularUncommon
Drug Interactions
- Other vasoconstrictors (e.g., norepinephrine, phenylephrine)Moderate
- Indomethacin and NSAIDsModerate
- NorepinephrineModerate
- EpinephrineModerate
- Vasodilators (e.g., nitroglycerin)Low
Population Constraints
- PregnancyReproductive SafetyRelative
- Pediatric patientsAgeRelative
- Patients with known coronary artery diseaseCardiovascularRelative
- Pregnant or breastfeeding womenReproductiveRelative
- Severe hepatic impairmentOrgan ImpairmentRelative
Regulatory Status
- European UnionUnapprovedNo EMA marketing authorization.
- United StatesUnapprovedInvestigational New Drug (IND) status; no FDA approval.
- United KingdomUnapprovedNot licensed by MHRA.
No FDA, EMA, or MHRA approval; studied in Phase II/III trials but development was discontinued after inconclusive efficacy results.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Selepressin?
Selepressin (FE‑202158) is a synthetic peptide analog of vasopressin with high affinity for V1a receptors. It has been studied intravenously for the treatment of septic shock to improve hemodynamics and reduce the need for other vasopressors. Development has not resulted in regulatory approval.
What is Selepressin used for?
Selepressin is educationally associated with: Reduction of norepinephrine requirements, Avoidance of V2-mediated adverse effects, Treatment of vasodilatory/septic shock, Restoration of vascular tone in distributive shock, Septic shock management. Educational only — not medical advice.
How is Selepressin administered?
Recorded routes of administration: Intravenous.
What are the potential side effects of Selepressin?
Reported adverse effects include: Hypertension, Reduced cardiac output, Digital/mesenteric ischemia, Peripheral ischemia (e.g., mesenteric, digital), Hyponatremia, Skin necrosis at infusion site, Bradycardia. This list is not exhaustive — consult a qualified clinician.
Who should avoid Selepressin?
Recorded contraindications: Known hypersensitivity to selepressin or its excipients, Hypersensitivity to selepressin or vasopressin analogues, Cardiogenic shock, Severe coronary artery disease or recent myocardial infarction, Severe peripheral vascular disease. Consult a qualified clinician before use.