Vasopressors

What is a vasopressor?

A vasopressor is a drug that healthcare providers use to make blood vessels constrict or become narrow in people with low blood pressure. Often, these are people in shock who are unable to get enough blood to their vital organs. Without oxygen-rich blood, your organs can’t function, which can be fatal. If IV fluids don’t bring your blood pressure up to a normal level, providers can put vasopressors in your IV to help bring your blood pressure up.

Healthcare providers usually give vasopressors through a central venous catheter, or central line, which is an IV tube that goes into a large vein. You may have fewer complications if it’s in your chest or neck instead of your arm.

What do vasopressors do?

Vasopressors constrict or tighten your blood vessels, making your heart have more forceful contractions. All of these help your body distribute blood to your vital organs.

Common vasopressors

Healthcare providers can treat you with these vasopressor drugs:

• Vasopressin (Pitressin® or Vasostrict®).
• Phenylephrine (Biorphen® or Vazculep®).
• Epinephrine.
• Norepinephrine.
• Dopamine.
• Angiotensin-II.
• Terlipressin.

Vasopressor examples

• You’re using a vasopressor when you use a nasal decongestant. Ephedrine and pseudoephedrine in these products constrict the blood vessels inside your nose.
• You have epinephrine in your pocket if you have a nut allergy and carry an EpiPen® Auto-Injector or Adrenalin® in case of an allergy attack.
• If you take Sudafed PE Cold/Cough®, Theraflu Cold and Cough® or many other cold or allergy medicines, you’re taking phenylephrine.

Vasopressors vs. inotropes

Healthcare providers often use both vasopressors and inotropes to help people who have shock or another condition with very low blood pressure. The two drugs have different jobs, though. Vasopressors make your blood vessels narrower to increase your blood pressure. Inotropes help your heart pump more blood. Together, these two drugs can help your body send more blood to your organs so they can keep running.

Who needs to have vasopressors?

Healthcare providers use vasopressors to increase your blood pressure when your blood pressure is too low, such as when you have:

• Shock.
• Polio.
• Heart attack.
• Heart failure.
• Spinal anesthesia.
• Blood transfusion.
• Sepsis.
• Drug reaction.
• Snakebite.

What do vasopressors treat?

Vasopressor therapy helps a number of conditions, including:

• Shock.
• Systolic heart failure (your heart can’t pump hard enough).
• Heart attack.
• Sepsis.
• Pulmonary embolism (blood clot).
• Aortic stenosis (narrowing of your aorta).
• Pulmonary hypertension (high blood pressure in your lungs).
• Cardiac tamponade (fluid around your heart pushes on it).
• Hypertrophic obstructive cardiomyopathy (thickened heart muscle).
• Cardiopulmonary resuscitation (CPR).

How common are vasopressors?

Vasopressors are a form of life support, just like dialysis or mechanical ventilation. Vasopressor therapy is a serious intervention that can only be done in the ICU and usually means someone has a critical medical condition. Healthcare providers use vasopressor drugs in about one-fourth of intensive care unit cases, according to one study.

What are the advantages of vasopressors?

Vasopressors are powerful drugs that work quickly to narrow your blood vessels and raise your blood pressure. Vasopressor drugs can save your life by helping your organs to keep functioning.

What are the side effects of vasopressors?

Your provider will check your vital signs and fluid levels frequently when treating you with a vasopressor drug. They’ll also keep checking to make sure your heart stays in a normal rhythm.

Vasopressor side effects include:

• Anxiety.
• Headache.
• Chest pain.
• Pulmonary edema (fluid in your lungs).
• Difficulty breathing.
• Bradycardia (slow heart rate).
• Thromboembolism (blood clot).
• Thrombocytopenia (low blood platelets).
• Tachycardia (fast heart rate).
• Ventricular arrhythmia (heart rhythm problem).
• Atrial fibrillation.
• Severe hypertension that could lead to bleeding in your brain or sudden cardiac death.

What is the recovery time?

Your recovery time depends on the reason you need vasopressors. Many people with septic shock don’t survive. If they do, they may be in the hospital for a number of weeks or even months.

When should I see my healthcare provider?

Call your provider if you start feeling sick again after you come home from the hospital.

A note from Cleveland Clinic

If you needed a vasopressor, you’ve probably been through a challenging illness. Give yourself time to get back to your normal routines. As you recover at home, be sure to take any medicines your provider prescribed and go to any scheduled office appointments.