Metabolic & endocrine
Vasopressin
The body's own antidiuretic nonapeptide, used intravenously in intensive care to support blood pressure in vasodilatory shock.
Also known as: antidiuretic hormone, ADH, arginine vasopressin, Vasostrict
Evidence passport
Last reviewed 2026-08-23
- Evidence level
- L5Practice-changing
- Confidence
- High confidence
- Human efficacy
- 80/100
- Human safety
- 75/100
- Regulatory status
- Approved medicine
- Development
- Approved
- Routes
- IV
- Evidence base
- Includes human data
- Furthest stage
- Approved
- Source curation
- Source curation pending
- Clinical maturity
- Approved critical-care medicine
Overview
Clinical maturity: Approved critical-care medicine
Routes & formulations
Studied / approved routes
The approved context is intravenous infusion in intensive care; there is no approved non-parenteral product for systemic use.
Route availability is not evidence of efficacy, and evidence from one route does not transfer to another. The Registry never provides dosing or sourcing information.
Peptide lifecycle
Discovery
Preclinical
Phase I
Phase II
Phase III
Approved
What it is
An endogenous nine-amino-acid hormone that constricts blood vessels via V1a receptors and promotes water retention via V2 receptors; synthetic vasopressin is given intravenously in shock states.
What people claim
- Raises blood pressure in vasodilatory (e.g. septic) shock
- Reduces catecholamine requirements in critical care
What the evidence actually says
Large randomised trials and decades of critical-care experience established its role as a vasopressor in vasodilatory shock. Its status as a natural hormone sometimes invites extrapolation to wellness contexts for which no evidence exists.
Human evidence
- Randomised controlled trials in vasodilatory and septic shock.
- Extensive critical-care haemodynamic and pharmacology data.
Preclinical evidence
- Vascular and renal receptor pharmacology of V1a/V2 agonism.
Animal and cell findings are Level 1–2 evidence.
Mechanism and pathways
- V1a-mediated vasoconstriction raises systemic vascular resistance; V2 activity promotes renal water reabsorption.
Safety and unknowns
- Labelled risks include ischaemic effects from vasoconstriction and hyponatraemia; use is monitored intensive-care therapy.
- No evidence supports research-market or wellness uses.
Cancer relevance
No concern identified
Regulatory status
Approved IV vasopressin products (e.g. Vasostrict) are indicated to increase blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. Approval is specific to that critical-care context.
Evidence grade
Replicated large randomised trials, pivotal Phase 3 programmes, or a major regulatory decision.
What would change our rating?
- Not applicable at this evidence tier.
References and sources
- To be curatedSources to be curated
Source hierarchy: regulatory documents and trial registries first, peer-reviewed work next, sponsor material flagged as non-independent. We never use supplier or clinic marketing as evidence, and where a verified source has not yet been curated we say so rather than inventing one.
Evidence change history
No recorded changes yet. Baseline position set on 2026-08-23.