Peptide LibraryTerlipressin
Terlipressin is a research peptide in the Vasopressin Receptor Agonist class. Terlipressin is a triglycyl-lysine derivative of vasopressin that is cleaved by endothelial peptidases to release lysine-vasopressin gradually, giving a longer effective duration than vasopressin itself. Preferential V1a activity produces splanchnic vasoconstriction, which reduces portal inflow and portal pressure and can redistribute blood volume toward the systemic and renal circulation.
For research use only.
Key Facts
- CAS
- 14636-12-5
- Molecular Weight (MW)
- 1227.4 g/mol
- Half-life
- Terminal half-life of 0.9 hours for terlipressin and 3.0 hours for its active metabolite lysine-vasopressin (Terlivaz label)
- FDA status
- Approved
- Evidence level
- FDA Approved
- Human dose established
- Yes
- Administration Route
- Intravenous
- Frequency
- Every 6 hours, by intravenous bolus over 2 minutes
- Last updated
- Nov 7, 2026
- Reviewed
- Nov 7, 2026
Research summary
Synthetic vasopressin prodrug approved in the United States to improve kidney function in adults with hepatorenal syndrome and rapid reduction in renal function. Used more widely outside the US for variceal bleeding.
Research evidence
- Regulatory review (FDA label)1 reviewed source
- Controlled human trialsNone in reviewed sources
- Early or uncontrolled human studiesNone in reviewed sources
- Lab & animal studiesNone in reviewed sources
How it works
Each step shows whether the sources Peptide Library has reviewed include that kind of research. Counts are reviewed sources, not every study ever published. Reviews and programme summaries that describe human use are shown as "reported", not as trials, and registered trials without published results are listed but not counted. A higher step means research has progressed further; it does not mean a compound works better or is safer. Compounds whose evidence has not been reviewed yet show "Not reviewed" instead of a guess.
Peptide Library's Terlipressin profile summarises 5 cited studies listed in the Science section, the compound's regulatory status, and research-protocol parameters reported for it. It is a research reference, not medical advice.
Terlipressin dosage evidence
Terlipressin has an FDA-approved human dosage as Terlivaz, to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function. The label gives 0.85 mg every 6 hours by slow intravenous bolus on days 1 to 3; on day 4 the dose stays the same, rises to 1.7 mg every 6 hours, or stops, depending on serum creatinine, for up to 14 days. The label carries a boxed warning for serious or fatal respiratory failure.
| Human dosing established | Yes |
|---|---|
| Studied dose range | 0.85–1.7 mg every 6 hours by intravenous bolus |
| Route | Intravenous |
| Frequency | Every 6 hours, by intravenous bolus over 2 minutes |
| Duration studied | Until 24 hours after two serum creatinine values of 1.5 mg/dL or less at least 2 hours apart, or a maximum of 14 days |
| Titration | Day 4: if serum creatinine has fallen by at least 30% from baseline, continue 0.85 mg every 6 hours; if it has fallen by less than 30%, the dose may be raised to 1.7 mg every 6 hours; if it is at or above baseline, stop. |
| Half-life | Terminal half-life of 0.9 hours for terlipressin and 3.0 hours for its active metabolite lysine-vasopressin (Terlivaz label) |
| Evidence level | FDA Approved |
| Last reviewed | 2026-11-07 |
Research-reported dosing
Doses as studied, one row per regimen. Different trials used different regimens; they are listed separately rather than averaged.
| Study / context | Population | Dose | Route | Frequency | Duration | Outcome studied | Source |
|---|---|---|---|---|---|---|---|
| FDA label — Terlivaz, hepatorenal syndromeFDA-approved label · FDA prescribing information | Adults with hepatorenal syndrome with rapid reduction in kidney function | 0.85 mg (one vial) on days 1 to 3; from day 4, 0.85 mg or 1.7 mg depending on the change in serum creatinine | Intravenous bolus over 2 minutes, through a peripheral or central line | Every 6 hours | Up to 14 days | Improved kidney function; studied in the CONFIRM trial, 300 adults randomised 2:1 to terlipressin or placebo, both with albumin | TERLIVAZ (terlipressin) for injection — FDA prescribing information, DailyMed |
Where sources disagree
- Boxed warning: Terlivaz may cause serious or fatal respiratory failure, with higher risk in people with volume overload or grade 3 acute-on-chronic liver failure. Oxygen saturation is checked before starting and monitored continuously, and treatment is not started, or is stopped, if it falls below 90%. In CONFIRM, serious or fatal respiratory failure occurred in 14% on Terlivaz against 5% on placebo.
- The label also warns of ischaemic events (heart, limbs or gut), adverse reactions that may make a patient ineligible for liver transplant, and harm to a fetus. It says people with a serum creatinine above 5 mg/dL are unlikely to benefit.
- Terlivaz 0.85 mg is equivalent to 1 mg of terlipressin acetate, the figure used in the trial; doses quoted in mg of terlipressin acetate are about 18% larger by number. It is a hospital medicine supplied as a 0.85 mg powder vial that is reconstituted with 5 mL of 0.9% sodium chloride.
Sequence & molecular data
| Molecular formula | C52H74N16O15S2 |
|---|---|
| Molecular weight | 1227.4 g/mol |
| CAS number | 14636-12-5 |
| PubChem CID | 72081 |
| FDA UNII | 7Z5X49W53P |
| ChEMBL | CHEMBL4088899 |
| DrugBank | DB02638 |
Identifiers link to the public PubChem, FDA Substance Registration (UNII), ChEMBL and DrugBank records for the same entity.
Science
Mechanism of Action
Terlipressin is a triglycyl-lysine derivative of vasopressin that is cleaved by endothelial peptidases to release lysine-vasopressin gradually, giving a longer effective duration than vasopressin itself. Preferential V1a activity produces splanchnic vasoconstriction, which reduces portal inflow and portal pressure and can redistribute blood volume toward the systemic and renal circulation.
Studies
- Terlipressin for Hepatorenal Syndrome in Patients With Early-Stage Acute-on-Chronic Liver Failure
- Noradrenaline or terlipressin for hepatorenal syndrome?
- Low-dose continuous terlipressin infusion is effective and safer than intravenous bolus injections in reducing portal pressure and control of acute variceal bleeding
- Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome
- Terlipressin Is Superior to Noradrenaline in the Management of Acute Kidney Injury in Acute on Chronic Liver Failure
Research statistics
1,125 PubMed publications · 45.8% human clinical research · 95 registered trials
Counts of published research through 2026-11-01, not evidence that it works. Publications by year, study types and trials · How publications are counted
Regulatory & research status
Terlipressin is an FDA-approved product for specific labelled indications. Approval does not extend to the research contexts described on this page, and approved products are prescription medicines.
| FDA status | Approved |
|---|---|
| Research status | Approved product (see FDA status) |
| Availability | Prescription-Only |
| WADA (sport) | Unknown / Not Listed |
| Library classification | FDA-Approved |
How FDA approval, compounding and research-only status differ
Benefits
—
Terlipressin side effects
No side effects listed yet for this entry.
Storage & stability
This compound is not supplied as a powder to be mixed, so the freeze-dried powder and reconstitution handling described for research peptides does not apply. Storage conditions are product-specific: follow the label or packaging of the product itself.
Terlipressin: frequently asked questions
What is Terlipressin?
Synthetic vasopressin prodrug approved in the United States to improve kidney function in adults with hepatorenal syndrome and rapid reduction in renal function. Used more widely outside the US for variceal bleeding.
How does Terlipressin work?
Terlipressin is a triglycyl-lysine derivative of vasopressin that is cleaved by endothelial peptidases to release lysine-vasopressin gradually, giving a longer effective duration than vasopressin itself. Preferential V1a activity produces splanchnic vasoconstriction, which reduces portal inflow and portal pressure and can redistribute blood volume toward the systemic and renal circulation.
Is Terlipressin FDA approved?
Yes. Terlipressin is approved by the FDA, and approved products are prescription medicines. Approval is always for specific indications studied in clinical trials, so an approved status does not mean the compound is approved for every use it is discussed for. Research-chemical material sold under the same name is not the approved product.
What peptides are similar to Terlipressin?
Compounds most often compared with Terlipressin include Vasopressin, Desmopressin, Angiotensin II and Cetrorelix. They are grouped by shared mechanism or research area rather than by equivalence, and their regulatory status and evidence base differ.
References
- Terlipressin for Hepatorenal Syndrome in Patients With Early-Stage Acute-on-Chronic Liver Failure — Liver Int, 2025External reference
- Noradrenaline or terlipressin for hepatorenal syndrome? — Medwave, 2015External reference
- Low-dose continuous terlipressin infusion is effective and safer than intravenous bolus injections in reducing portal pressure and control of acute variceal bleeding — Hepatol Int, 2023External reference
- Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome — N Engl J Med, 2021External reference
- Terlipressin Is Superior to Noradrenaline in the Management of Acute Kidney Injury in Acute on Chronic Liver Failure — Hepatology, 2020External reference
Related research, comparisons & guides
Related peptides
Compiled by Peptide Library Editorial · Reviewed Aug 30, 2026 · Updated Nov 7, 2026 · Version 2
This Terlipressin profile is compiled from published literature (5 cited studies linked above), public regulatory records and chemical registries. It describes what research reports; it is not medical advice, and nothing here is a dosing recommendation for humans. Peptide Library does not sell peptides. Editorial policy · How profiles are compiled · Report an error
Track Terlipressin research, inventory and reconstitution in the free Peptide Library app. Get the app for iOS or Android →