MIMS May prescribing update

  • Lucassin (terlipressin) is a synthetic vasopressin analogue that acts as a systemic vasoconstrictor, via vasopressin 1a (V1a) receptors, both as a pro-drug for lysine-vasopressin and having pharmacologic activity on its own, albeit of lower potency than lysine-vasopressin. It increases mean arterial pressure and decreases heart rate while increasing systemic vascular resistance. In hepatorenal syndrome (HRS) patients with hyperdynamic circulation, the V1 receptor-mediated vasoconstrictor activity of terlipressin, particularly in the splanchnic area, results in an increase in mean arterial pressure, normalisation of endogenous vasoconstrictor systems (renin-angiotensin-aldosterone and sympathetic nervous system), and an increase in renal blood flow. The therapeutic rationale for treatment of HRS with the drug is that these effects may result in improved renal function. Lucassin is indicated for the treatment of patients with HRS type 1 who are actively being considered for a