T-STAT
Clinical safety rating: caution
Comprehensive clinical and safety monograph for T-STAT (T-STAT).
T-STAT (terlipressin) is a synthetic vasopressin analog that selectively activates V1 receptors on vascular smooth muscle, causing splanchnic vasoconstriction and reducing portal venous pressure.
| Metabolism | Primarily metabolized by lysosomal proteolysis via cathepsins and other peptidases; not CYP450 dependent. |
| Excretion | Primarily renal excretion as unchanged drug (70-80%) and metabolites; 10-15% excreted in feces via biliary elimination. |
| Half-life | Terminal elimination half-life: 2.5-4.5 hours; prolonged in renal impairment (up to 18 hours in severe cases). |
| Protein binding | Approximately 85% bound primarily to albumin; minor binding to alpha-1-acid glycoprotein. |
| Volume of Distribution | Apparent volume of distribution: 0.9-1.5 L/kg, suggesting extensive distribution into total body water and some tissue binding. |
| Bioavailability | Oral: 60-70% due to first-pass metabolism; intramuscular: 90-100%; intravenous: 100%. |
| Onset of Action | Intravenous: within 1-2 minutes; intramuscular: 5-10 minutes; oral: 30-60 minutes. |
| Duration of Action | 3-6 hours following intravenous administration; extended with higher doses or in hepatic impairment. |
| Action Class | Antifibrinolytic |
| Brand Substitutes | Trenaxa 1000 Tablet, Pause 1000mg Tablet, T Syl 100mg Injection, Tranarest 100mg Injection, Coastat 100mg Injection, Tromic 100mg Injection, Trim 100mg Injection |
T-STAT: 100 mg intravenously twice daily for 14 days.
| Dosage form | SOLUTION |
| Renal impairment | GFR ≥30 mL/min: No adjustment. GFR <30 mL/min: Not recommended (limited data). |
| Liver impairment | Child-Pugh A: No adjustment. Child-Pugh B or C: Contraindicated. |
| Pediatric use | Children (≥2 years): 2 mg/kg intravenously every 12 hours, maximum 100 mg per dose. |
| Geriatric use | No specific dose adjustment recommended; monitor renal function closely. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for T-STAT (T-STAT).
| Breastfeeding | Not recommended during breastfeeding due to potential for infant anticholinergic effects (e.g., tachycardia, sedation); M/P ratio not established. |
| Teratogenic Risk | First trimester: Not teratogenic in animal studies at clinically relevant doses; limited human data. Second/third trimester: No known fetal risks; may cause transient neonatal tachycardia if used near term due to anticholinergic effects. |
| Fetal Monitoring |
■ FDA Black Box Warning
T-STAT is associated with serious or fatal respiratory failure due to hypoxia and fluid overload. Patients with acute kidney injury and underlying respiratory compromise are at increased risk.
| Serious Effects |
["Hypersensitivity to terlipressin or any component","Uncontrolled hypertension","Severe coronary artery disease","Acute mesenteric ischemia","Pregnancy (may cause uterine contractions and fetal hypoxia)"]
| Precautions | ["Monitor oxygenation and fluid status closely due to risk of respiratory failure and volume overload","May cause peripheral and mesenteric ischemia, especially in patients with cardiovascular disease","Electrolyte disturbances including hyponatremia and hyperkalemia","Use with caution in patients with asthma, COPD, or other pulmonary conditions"] |
Loading safety data…
| Monitor maternal heart rate and blood pressure during infusion; fetal heart rate monitoring recommended if used near term. |
| Fertility Effects | No evidence of impaired fertility in animal studies; human data insufficient. |