Giapreza (angiotensin II acetate, human)

Dosage of angiotensin II acetate is expressed in terms of angiotensin II.

Angiotensin II acetate is administered by continuous IV infusion. It is recommended that the drug be infused through a central venous line.

Prior to administration, the commercially available injection concentrate must be diluted in 0.9% sodium chloride injection to a final concentration of 5000 or 10,000 ng/mL depending on the patient's fluid status. In patients who are not fluid restricted, a concentration of 5000 ng/mL may be prepared by adding 1 mL (2.5 mg) of the injection concentrate to an infusion bag containing 500 mL of 0.9% sodium chloride injection. In patients who are fluid restricted, a concentration of 10,000 ng/mL may be prepared by adding 1 mL (2.5 mg) of the injection concentrate to an infusion bag containing 250 mL of 0.9% sodium chloride injection. Diluted solutions may be stored at room temperature or under refrigeration for up to 24 hours.

Solutions of angiotensin II should be inspected visually for particulate matter and discoloration prior to administration.

No dosing information is available for this tab.

No drug interaction studies have been performed to date with angiotensin II acetate. Concomitant use of angiotensin-converting enzyme (ACE) inhibitors may increase the response to angiotensin II and concomitant use of angiotensin II receptor antagonists (ARBs) may decrease the response to angiotensin II.

There are no contraindication interactions for this drug.

Severe Interaction: Action is required to reduce the risk of severe adverse interaction.

Myelosuppressives; Immunomodulators/Sodium Iodide I 131

SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.

MECHANISM OF ACTION: Sodium iodide I 131 can cause depression of the hematopoetic system. Myelosuppressives and immunomodulators also suppress the immune system.(1)

CLINICAL EFFECTS: Concurrent use of sodium iodide I 131 with agents that cause bone marrow depression, including myelosuppressives or immunomodulators, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding.(1)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: The US manufacturer of sodium iodide I 131 states that concurrent use with bone marrow depressants may enhance the depression of the hematopoetic system caused by large doses of sodium iodide I 131.(1) Sodium iodide I 131 causes a dose-dependent bone marrow suppression, including neutropenia or thrombocytopenia, in the 3 to 5 weeks following administration. Patients may be at increased risk of infections or bleeding during this time. Monitor complete blood counts within one month of therapy. If results indicate leukopenia or thrombocytopenia, dosimetry should be used to determine a safe sodium iodide I 131 activity.(1)

DISCUSSION: Hematologic disorders including death have been reported with sodium iodide I 131. The most common hematologic disorders reported include anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia.(1)

There are no moderate interactions for this drug.

The manufacturer states that there are no known contraindications to the use of angiotensin II acetate.

There are no contraindication contraindications for this drug.

• Deep venous thrombosis
• Thromboembolic disorder

There are no moderate contraindications for this drug.

Adverse reactions reported in 4% or more of patients receiving angiotensin II in clinical studies include thromboembolic events (e.g., DVT), thrombocytopenia, tachycardia, fungal infection, delirium, acidosis, hyperglycemia, and peripheral ischemia.

More Frequent

• Thromboembolic disorder

Less Frequent

• Acidosis
• Deep venous thrombosis
• Peripheral ischemia
• Thrombocytopenic disorder

Less Frequent

• Delirium
• Fungal infection
• Hyperglycemia
• Tachycardia

No enhanced messaging available.

Safety and efficacy of angiotensin II have not been established in pediatric patients.

There are insufficient data in pregnant women to determine whether angiotensin II is associated with a risk of adverse developmental effects. Animal reproduction studies have not been conducted with the drug.

Septic or other distributive shock is a medical emergency that can be fatal if untreated; a delay in treatment in pregnant women with hypotension associated with shock is likely to increase the risk of maternal and fetal morbidity and mortality.

It is not known whether angiotensin II is distributed into human milk of if the drug has any effects on the nursing infant or on milk production.

In the ATHOS-3 study, 48% of the total patient population was 65 years of age or older. No substantial differences in safety or efficacy of angiotensin II have been observed between geriatric patients (65 years of age or older) and younger adults.