Possible Interaction: Albumin and Terlipressin

“Serum creatinine levels were significantly decreased from 2.84 ± 0.45 to 1.08 ± 0.33 mg/dl (−61.9 ± 9.9%, p < 0.05) after terlipressin and albumin administration.”

“One could speculate that albumin might enhance the vasoconstrictive response to terlipressin , thus contributing to counterbalance the negative effects of systemic vasodilation, which characterizes the hyperdynamic circulation of cirrhotic patients.”

“Albumin administration was the only predictive factor of complete response (77% in patients receiving terlipressin and albumin vs. 25% in those receiving terlipressin alone, P = .03).”

“ Albumin appears to improve markedly the beneficial effects of terlipressin.”

“The long-term administration (1-3 weeks) of analogs of vasopressin (ornipressin or terlipressin ) or other vasoconstrictors together with plasma volume expansion with albumin is associated with a dramatic improvement in circulatory function and normalization of serum creatinine concentration in patients with severe hepatorenal syndrome.”

“We nevertheless suspect the reported treatment advantage of terlipressin is conditionally subject to the conjunctional use of high dose of albumin (60g/day).”

“We therefore speculated that it is the high dose albumin that has potentiated the full therapeutic power of terlipressin by remedying its haemodynamic shortcomings.”

“Low- or very low-certainty evidence also found that albumin plus midodrine plus octreotide and albumin alone had lower recovery from hepatorenal syndrome compared with albumin plus terlipressin.”

“The most common interventions compared were albumin plus terlipressin , albumin plus noradrenaline, and albumin alone.”

“ DiscussionTerlipressin combined with albumin shows strong evidence of improving short-term survival in patients with type 1 but not type 2 HRS.”

“Rates of complete HRS reversal were significantly higher with terlipressin and noradrenaline combined with albumin than with placebo (OR 6.65, 95% CI: 2.08–21.31 and 6.81, 95% CI: 1.87–24.83, respectively).”

“Cardiac output and portal flow decreased, whereas systemic vascular resistance increased significantly in terlipressin and albumin plus terlipressin groups compared with the albumin group after 3 and 10 days.”

“In conclusion, available data are sufficient to state that the use of terlipressin plus albumin has really changed the management of HRS.”

“Several small studies and some randomized control studies have been published on the use of terlipressin plus albumin in the treatment of HRS, mainly on AKI-HRS.”

“ Terlipressin and albumin co-treatment is associated with increased two-months survival rate.”