Terlipressin Reconstitution and Dilution
Reconstitute each 0.85 mg vial of terlipressin with 5 mL of 0.9% sodium chloride injection (normal saline) immediately before use. 1
Standard Reconstitution Protocol
- Each single-dose vial containing 0.85 mg of terlipressin as lyophilized powder must be reconstituted with exactly 5 mL of 0.9% sodium chloride injection USP 1
- The reconstituted solution should be administered intravenously through a peripheral line 2
- After administration, flush the IV line to ensure complete delivery of the dose 1
- Discard any unused portion after reconstitution, as the vials are preservative-free and intended for single-dose use only 1
Dosing Considerations for 1 gram (1000 mg)
- Important caveat: The question asks about diluting "1 gm" (1000 mg) of terlipressin, but this represents an extraordinarily high dose that far exceeds any recommended therapeutic regimen 2, 3, 1
- Standard therapeutic doses range from 0.85 mg to a maximum of 12 mg per day, making 1 gram approximately 83-1176 times the typical daily dose 2, 3, 1
- If the intent is to prepare multiple doses from bulk supply, each 0.85 mg vial should be reconstituted individually as needed, rather than preparing a large batch 1
Administration Method
- Terlipressin can be administered either as intermittent IV boluses every 4-6 hours or as continuous IV infusion 2, 3, 4
- For bolus administration: reconstitute each vial with 5 mL normal saline and administer the entire contents intravenously 1
- For continuous infusion: the starting dose is typically 2 mg/day, which would require reconstituting multiple vials and adding them to an appropriate volume of compatible IV fluid 2, 3, 4
- Continuous infusion has been shown to cause fewer adverse events (35% vs 62%) compared to bolus dosing while maintaining similar efficacy 4