Vasopressin (ADH)
Also known as: Antidiuretic Hormone, ADH, Arginine Vasopressin, Pitressin
Overview
Arginine vasopressin (AVP/ADH) is a 9-amino acid neuropeptide produced in hypothalamic paraventricular and supraoptic nuclei and released from the posterior pituitary in response to increased plasma osmolality or decreased blood volume. It is essential for water homeostasis via antidiuresis, and at higher concentrations acts as a powerful vasoconstrictor (hence 'vasopressin'). In critical care, vasopressin is used as a vasopressor in septic shock and as an adjunct to resuscitation algorithms. Its analogs—desmopressin (antidiuresis-selective) and terlipressin (splanchnic-selective)—are more widely used clinically.
Mechanism of Action
Vasopressin activates three receptors: V1a (vascular smooth muscle → vasoconstriction via Gq/PLC/Ca2+ pathway), V1b/V3 (pituitary corticotrophs → ACTH release), and V2 (renal collecting duct → AQP2-mediated antidiuresis via Gs/cAMP/PKA). In septic shock, V1a activation counteracts the profound vasoplegia of vasodilatory shock, restoring vascular tone. V2 activation in the kidney causes AQP2 membrane translocation and maximal water reabsorption, crucial for plasma osmolality regulation. In the brain, AVP modulates social behavior, stress responses, and circadian rhythms.
Potential Benefits
- Critical care vasopressor for vasodilatory/septic shock
- Antidiuresis and plasma osmolality regulation
- Cardiac arrest vasopressor in ACLS protocols
- Template for desmopressin and terlipressin development
- Neuromodulator for social behavior and stress responses
Dosage Protocols
The following reflects doses used in published research studies. This is not medical advice. Consult a qualified healthcare professional.
| Beginner | Hospital use for acute indications |
| Intermediate | N/A — all uses are medically supervised |
| Advanced | N/A |
| Cycle Duration | Acute (shock) or chronic (DI) |
FDA-approved (Vasostrict) for septic shock vasopressor support. Desmopressin preferred for DI due to V2 selectivity.
Use our Reconstitution Calculator to determine exact syringe units for your protocol.
Routes of Administration
Intravenous Infusion 100%
Primary use — septic shock vasopressor infusion.
Intramuscular / Subcutaneous High
Historical use for central DI — replaced by desmopressin.
Read our full Routes of Administration Guide for detailed comparison of all delivery methods.
Stacking Protocols
Popular research stacks involving Vasopressin (ADH):
Septic Shock Protocol
VASST-guided second-line vasopressor support in septic shock — add vasopressin 0.03 U/min to norepinephrine.
Explore our complete Peptide Stacking Guide for more combinations and safety considerations.
Reconstitution
| Storage | Refrigerate 2-8°C. Diluted solution stable 18 hours at room temperature. |
|---|
Hospital pharmacy preparation.
Need exact syringe measurements?
Amino Acid Sequence
Cys-Tyr-Phe-Gln-Asn-Cys-Pro-Arg-Gly-NH2 (cyclic via disulfide Cys1-Cys6)
Side Effects & Safety
- Hypertension and excessive vasoconstriction
- Peripheral ischemia at high doses
- Hyponatremia
- Cardiac arrhythmias
- Mesenteric ischemia at high doses
Safety & Contraindications
This information is for educational purposes only. Consult a qualified healthcare provider before using any peptide.
Pregnancy / Lactation
Bleeding Disorders
Active Skin Infection at Injection Site
FDA Safety Information
FDA labeling warns of risk of cardiac/mesenteric/peripheral ischemia, water intoxication, and hypersensitivity reactions.
Pharmacokinetics
| Half-Life | ~10-20 minutes |
|---|---|
| Storage | Refrigerate at 2-8°C. Do not freeze. Protect from light. |
Synergistic Compounds
The following compounds have been studied alongside Vasopressin (ADH) for potential complementary or synergistic effects:
Learn More
References & Further Reading
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