Heart & blood V1/V2 receptor agonist
Vasopressin
Regulatory status
Status at a glance
503A compounding status
Not nominated
We found no pending nomination for the 503A bulks list. Unless the substance has another legal pathway (for example, a USP monograph or use in an FDA-approved drug), 503A pharmacies generally may not compound with it.
- FDA approval
- An FDA-approved product contains this peptide
- 503B outsourcing
- Not determined
- Anti-doping (WADA)
- Not on the WADA Prohibited List
- DEA schedule
- Not a controlled substance
About peptide status
Most peptides discussed here are not FDA-approved for any use, and products labeled “research use only” are not for human use. Removal from Category 2 does not authorize compounding. PCAC votes are non-binding recommendations; FDA and HHS make the final decisions.
This is not medical or legal advice, and we do not publish dosing, sourcing or reconstitution information. Talk with a licensed clinician before using any peptide.
If you think you are having a medical emergency, call 911.
Key takeaway
Vasopressin (sold as Vasostrict) is a synthetic copy of the body's antidiuretic hormone, used in intensive care to raise blood pressure in patients whose blood vessels have lost tone despite other treatment. It tightens blood vessels through a pathway independent of the usual catecholamine drugs. The formally approved product has been FDA-approved in the U.S. since 2014 and is given as a continuous intravenous infusion.
At a glance
- What it is
- Synthetic arginine vasopressin, a vasoconstrictor and antidiuretic hormone
- Approved for
- Raising blood pressure in adults with vasodilatory (for example septic) shock who remain low despite fluids and catecholamines
- Key fact
- In the VASST trial, adding vasopressin to norepinephrine did not reduce overall mortality versus norepinephrine alone
- Route
- Intravenous infusion
- Evidence strength
- FDA approved
Summary
Vasopressin (Vasostrict) is an FDA-approved hormone used in intensive care to raise blood pressure. Learn how it works, its uses, and side effects.
What is vasopressin?
Vasopressin, sold under the brand Vasostrict, is a synthetic form of arginine vasopressin, the hormone the body releases to conserve water and, at higher levels, to constrict blood vessels. In critical care it is used as a vasopressor, a drug that raises dangerously low blood pressure. Although vasopressin had been used clinically for many years under older marketing arrangements, Vasostrict became the first fully FDA-approved vasopressin injection in 2014.
How does vasopressin work?
Vasopressin raises blood pressure mainly through V1a receptors on the smooth muscle of blood vessels, and it also acts at the kidney's V2 receptors. The table below compares the two.
| Receptor | Where it sits | Effect of activation |
|---|---|---|
| V1a | Smooth muscle of blood vessels | Triggers the vessel wall to contract, increasing systemic vascular resistance and blood pressure |
| V2 | Kidney | Promotes water reabsorption, its antidiuretic effect |
Importantly, this blood-pressure action works through a different signaling pathway than the catecholamine vasopressors such as norepinephrine, so vasopressin can add blood-pressure support when those drugs alone are not enough, including in states where their receptors have become less responsive.
In vasodilatory shock, such as septic shock, the blood vessels are pathologically relaxed, and vasopressin helps restore tone. The evidence shows it supports blood pressure but does not necessarily improve survival: in the VASST trial, adding low-dose vasopressin to norepinephrine did not reduce 28-day mortality compared with norepinephrine alone, though a subgroup with less severe shock showed possible benefit. It is used to maintain pressure and reduce the dose of other vasopressors.
Is it FDA-approved?
Editor’s note
Status: Yes. Vasopressin injection (Vasostrict) received full FDA approval in 2014 to raise blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. It is given as a continuous intravenous infusion in a monitored setting.
Category: FDA-approved · Primary body area: Heart & blood
Yes. Vasopressin injection (Vasostrict) received full FDA approval in 2014 to raise blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. It is given as a continuous intravenous infusion in a monitored setting.
What is vasopressin prescribed for?
Vasopressin is used to increase blood pressure in adults with vasodilatory shock, such as septic or post-cardiotomy shock, who are not responding adequately to fluid resuscitation and catecholamine vasopressors. It is an intensive-care medication, not an outpatient treatment.
What are the side effects?
According to the prescribing information, common side effects include:
- Decreased cardiac output
- Slowed heart rate or arrhythmia
More serious considerations include:
- Reduced blood flow to the heart, gut, fingers, toes, or skin, which can cause tissue damage
- Low blood sodium
- Tissue injury if the infusion leaks out of the vein
Sources: FDA prescribing information for Vasostrict; the VASST trial (Russell et al., The New England Journal of Medicine, 2008, DOI: 10.1056/NEJMoa067373), indexed on PubMed. This document is educational and does not constitute medical advice.
Registered human trials
0 registered human trials on ClinicalTrials.gov that we reviewed
Sources
- [1]
- [2]
Compare every peptide’s status in the peptide regulatory status database
More for Heart & blood
View all heart & blood peptides →- FDA-approved Heart & blood
Angiotensin-Ii
Angiotensin II is a natural peptide hormone and the main active signal of the renin-angiotensin system, which the body uses to raise blood pressure by tightening blood vessels. A synthetic version is FDA-approved as Giapreza, an intravenous drug given in intensive care to raise dangerously low blood pressure in adults with septic or other distributive shock. In its pivotal ATHOS-3 trial it raised blood pressure in about 70% of patients compared with 23% on placebo, though it also carries a risk of blood clots.
- In clinical trials Heart & blood
Balixafortide
Balixafortide is an investigational peptide that blocks the CXCR4 receptor, studied by Polyphor in combination with chemotherapy for metastatic breast cancer. An early single-arm trial suggested activity, but the pivotal Phase 3 trial did not show a benefit over chemotherapy alone, and development has effectively stopped. As of 2026 it is not approved.
- FDA-approved Heart & blood
Bivalirudin
Bivalirudin is a synthetic 20-amino acid peptide anticoagulant, derived in design from the leech protein hirudin, that directly and reversibly blocks thrombin, the central enzyme in blood clotting. Sold as Angiomax, it is given intravenously during coronary procedures such as angioplasty and stenting to prevent clots, including in people who cannot receive heparin. In a large trial of heart-attack patients, using it instead of heparin plus a second blood thinner reduced major bleeding and lowered 30-day death rates.
- FDA-approved Heart & blood
Desirudin
Desirudin (formerly sold as Iprivask) is a recombinant form of hirudin, the natural anticoagulant from the medicinal leech, that was used to prevent blood clots after hip replacement surgery. It directly and specifically blocks thrombin, the central enzyme of the clotting cascade. It was FDA-approved in the U.S. in 2003, but Iprivask has since been discontinued and no desirudin product is currently sold in the U.S.
- FDA-approved Heart & blood
Desmopressin
Desmopressin (desmopressin acetate; brands include DDAVP and Nocdurna) is a synthetic version of the antidiuretic hormone vasopressin, engineered to concentrate urine without raising blood pressure. It treats central diabetes insipidus, bedwetting, nighttime urination, and certain bleeding disorders. It has been FDA-approved in the U.S. since 1978 and comes as tablets, a sublingual form, nasal spray, and injection.
- FDA-approved Heart & blood
Echinocandins
The echinocandins (caspofungin, micafungin, and anidulafungin; sold as Cancidas, Mycamine, and Eraxis) are antifungal lipopeptides that attack the fungal cell wall, a structure human cells lack. They are a preferred option for invasive Candida infections and are generally well tolerated. All three have been FDA-approved in the U.S. since the 2000s, a fourth (rezafungin, sold as Rezzayo) was approved in 2023, and all are given intravenously.