When HRS-AKI strikes, time is of the essence
TERLIVAZ (terlipressin) IS THE FRONT LINE OF HRS-AKI TREATMENT1,2
The first and only FDA-approved therapy to improve kidney function in adults with HRS with rapid reduction in kidney function1
When HRS-AKI strikes, time is of the essence
TERLIVAZ (terlipressin) IS THE FRONT LINE OF HRS-AKI TREATMENT1,2
The first and only FDA-approved therapy to improve kidney function in adults with HRS with rapid reduction in kidney function1
Urgency matters in HRS-AKI
Historically, patients with HRS-AKI have faced poor outcomes, with or without treatment.3,4,a,b
Consider the preferred treatment for HRS-AKI2,5
Find out more about recommended therapies for HRS-AKI, including the preferred treatment option.
Flexible administration
TERLIVAZ can be administered on the floor without a dedicated central line.1
FDA, US Food and Drug Administration; HRS-AKI, hepatorenal syndrome–acute kidney injury.
aTreated patients were identified based on International Classification of Diseases (ICD) coding, which does not differentiate types of hepatorenal syndrome (HRS).4
bReason for discharge among treated patients varied and was not necessarily indicative of patient outcomes.4
IMPORTANT SAFETY INFORMATION
WARNING: SERIOUS OR FATAL RESPIRATORY FAILURE
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TERLIVAZ® may cause serious or fatal respiratory failure. Patients with volume overload or with acute-on-chronic liver failure (ACLF) Grade 3 are at increased risk. Assess oxygenation saturation (e.g., SpO2) before initiating TERLIVAZ.
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Do not initiate TERLIVAZ in patients experiencing hypoxia (e.g., SpO2 <90%) until oxygenation levels improve. Monitor patients for hypoxia using continuous pulse oximetry during treatment and discontinue TERLIVAZ if SpO2 decreases below 90%.
INDICATION
TERLIVAZ is indicated to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function.
LIMITATION OF USE
Patients with a serum creatinine >5 mg/dL are unlikely to experience benefit.
Contraindications
TERLIVAZ is contraindicated:
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In patients experiencing hypoxia or worsening respiratory symptoms.
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In patients with ongoing coronary, peripheral, or mesenteric ischemia.
Warnings and Precautions
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Serious or Fatal Respiratory Failure: Obtain baseline oxygen saturation and do not initiate TERLIVAZ in hypoxic patients. Monitor patients for changes in respiratory status using continuous pulse oximetry and regular clinical assessments. Discontinue TERLIVAZ in patients experiencing hypoxia or increased respiratory symptoms.
Manage intravascular volume overload by reducing or discontinuing the administration of albumin and/or other fluids and through judicious use of diuretics. Temporarily interrupt, reduce, or discontinue TERLIVAZ treatment until patient volume status improves. Avoid use in patients with ACLF Grade 3 because they are at significant risk for respiratory failure.
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Ineligibility for Liver Transplant: TERLIVAZ-related adverse reactions (respiratory failure, ischemia) may make a patient ineligible for liver transplantation, if listed. For patients with high prioritization for liver transplantation (e.g., MELD ≥35), the benefits of TERLIVAZ may not outweigh its risks.
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Ischemic Events: TERLIVAZ may cause cardiac, cerebrovascular, peripheral, or mesenteric ischemia. Avoid use of TERLIVAZ in patients with a history of severe cardiovascular conditions or cerebrovascular or ischemic disease. Discontinue TERLIVAZ in patients who experience signs or symptoms suggestive of ischemic adverse reactions.
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Embryo-Fetal Toxicity: TERLIVAZ may cause fetal harm when administered to a pregnant woman. If TERLIVAZ is used during pregnancy, the patient should be informed of the potential risk to the fetus.
Adverse Reactions
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The most common adverse reactions (≥10%) include abdominal pain, nausea, respiratory failure, diarrhea, and dyspnea.
Please see full Prescribing Information, including BOXED WARNING.
References: 1. TERLIVAZ® (terlipressin). Prescribing Information. Bridgewater, NJ: Mallinckrodt Hospital Products Inc. 2. Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(2):1014-1048. doi:10.1002/hep.31884 3. Flamm SL, Brown K, Wadei HM, et al. The current management of hepatorenal syndrome-acute kidney injury in the United States and the potential of terlipressin. Liver Transpl. 2021;27(8):1191-1202. doi:10.1002/lt.26072 4. Jamil K. Huang X, Lovelace B, Pham AT, Lodaya K, Wan G. The burden of illness of hepatorenal syndrome (HRS) in the United States: a retrospective analysis of electronic health records. J Med Econ. 2019;22(5):421-429. doi:10.1080/13696998.2019.1580201 5. Bajaj JS, O’Leary JG, Lai JC, et al. Acute-on-chronic liver failure clinical guidelines. Am J Gastroenterol. 2022;117(2):225-252. doi:10.14309/ajg.ODOODODDODOOl595