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Terlipressin Induced Severe Hyponatremia
Martin Šíma1, Miroslav Pokorný2, František Paďour2
1Institute of Pharmacology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic. sima.mart@seznam.cz.
Prague Medical Report
|March 21, 2016
Summary
Terlipressin, used for variceal bleeding, can cause severe hyponatremia. Monitoring fluid retention after the first dose may predict this adverse reaction in cirrhotic patients.
Area of Science:
- Hepatology
- Pharmacology
- Nephrology
Background:
- Terlipressin is a vasopressin analogue prescribed for variceal bleeding.
- While generally safe, terlipressin can cause adverse reactions like hyponatremia.
Observation:
- A cirrhotic patient experienced severe hyponatremia during two separate hospitalizations for variceal bleeding.
- Hyponatremia developed during terlipressin treatment periods and resolved after drug discontinuation.
Findings:
- A strong causal link between terlipressin administration and hyponatremia was established through dechallenge and rechallenge.
- Significant fluid retention preceded hyponatremia in both treatment episodes.
Implications:
- Early fluid balance monitoring after the initial terlipressin dose is crucial for predicting hyponatremia risk.
- This monitoring may offer a more reliable individual risk assessment than traditional risk factors.
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