Peptides for Critical Care
Overview
3 research peptides are currently studied for critical care. This guide ranks them by evidence strength and covers their mechanisms, safety profiles, and current clinical status.
Vasopressin — Approved Medication with Strong Human Data
Evidence Rating: A Category: Reproductive / Hormonal
Vasopressin (arginine vasopressin, AVP) is an endogenous cyclic nonapeptide hormone (Cys-Tyr-Phe-Gln-Asn-Cys-Pro-Arg-Gly-NH2, MW ~1084.2 g/mol) synthesized in the hypothalamus and released from the posterior pituitary. It regulates water reabsorption in the renal collecting ducts via V2 receptors an...
Key claims: Effective in vasodilatory shock; Used in cardiac arrest algorithms.
Terlipressin — Approved Medication with Strong Human Data
Evidence Rating: A Category: Reproductive / Hormonal
Terlipressin is a synthetic vasopressin analog (MW ~1227.4 g/mol) that acts as a prodrug, slowly converted by tissue peptidases to the active metabolite lysine vasopressin. It was FDA-approved in September 2022 (Terlivaz) for hepatorenal syndrome type 1 (HRS-1), making it the first pharmacotherapy s...
Key claims: Improves renal function in hepatorenal syndrome type 1; First FDA-approved therapy for hepatorenal syndrome.
Angiotensin II — FDA Approved
Evidence Rating: A Category: Cardiovascular / Vasoactive
Angiotensin II is an endogenous 8-amino-acid peptide (sequence: Asp-Arg-Val-Tyr-Ile-His-Pro-Phe, MW ~1046.2 g/mol) that serves as the primary effector of the renin-angiotensin-aldosterone system (RAAS). A synthetic form (Giapreza, La Jolla Pharmaceutical) was FDA-approved in December 2017 for the tr...
Key claims: Raises blood pressure in catecholamine-resistant vasodilatory shock; Allows reduction in background vasopressor requirements.