--- title: "Terlipressin" canonical_url: https://peptidelibrary.app/library/terlipressin description: "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." updated: 2026-11-07 publisher: Peptide Library notice: "Research and educational use only. Not medical advice." --- # Terlipressin 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. 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. ## Classification - Type: FDA-approved vasopressin prodrug - Mechanism class: Vasopressin Receptor Agonist - Development stage: Approved product - Regulatory class: FDA-approved medicine ## Mechanism 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. ## Properties - Molecular formula: C52H74N16O15S2 - Molecular weight: 1,227.4 g/mol - CAS number: 14636-12-5 - Half-life: Terminal half-life of 0.9 hours for terlipressin and 3.0 hours for its active metabolite lysine-vasopressin (Terlivaz label) - Studied routes: Intravenous ## Evidence - Evidence level: FDA Approved - Highest documented: Regulatory review (FDA label) - Human trials: 0 - Controlled human trials: 0 - Preclinical sources: 0 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. ### Studies 1. TERLIVAZ (terlipressin) for injection — FDA prescribing information, DailyMed. Regulatory label (FDA), human. Population: Adults with hepatorenal syndrome with rapid reduction in kidney function. Improved kidney function; studied in the CONFIRM trial, 300 adults randomised 2:1 to terlipressin or placebo, both with albumin [Source](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3a35b86c-f451-4fac-8499-43019e4da354) ## Safety Human safety basis: FDA prescribing information ## Regulatory 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 - Availability: Prescription-Only ## 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, 2025](https://pubmed.ncbi.nlm.nih.gov/41200852/) - [Noradrenaline or terlipressin for hepatorenal syndrome? — Medwave, 2015](https://pubmed.ncbi.nlm.nih.gov/26334297/) - [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, 2023](https://pubmed.ncbi.nlm.nih.gov/36542261/) - [Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome — N Engl J Med, 2021](https://pubmed.ncbi.nlm.nih.gov/33657294/) - [Terlipressin Is Superior to Noradrenaline in the Management of Acute Kidney Injury in Acute on Chronic Liver Failure — Hepatology, 2020](https://pubmed.ncbi.nlm.nih.gov/30076614/)