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Vasopressin

Also known as: ADH, antidiuretic hormone, arginine vasopressin, AVP, Vasostrict, Pitressin, AVP injection, 8-arginine vasopressin

Endogenous nonapeptide hormone; posterior pituitary hormone; vasopressor; antidiuretic agent

Research chemicalLast updated: October 10, 2026Based on 9 peer-reviewed studiesPreclinical data only — no human trials
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What it is

Vasopressin is a natural hormone that doctors use as an emergency medicine to raise blood pressure in people in shock, and to treat a rare kidney condition where the body wastes too much water. The body makes it naturally in the brain; injectable versions are FDA-approved for hospital and at-home use under the brand names Vasostrict and Pitressin.

The scientific side

Vasopressin is described as a nine-amino acid peptide hormone synthesized in the hypothalamus and released from the posterior pituitary gland, where it serves as a master regulator of osmotic and cardiovascular homeostasis. It acts through three distinct G protein-coupled receptor subtypes — V1a, V1b, and V2 — each mediating different physiological effects (PMID 32138953). V1a receptor activation on vascular smooth muscle triggers vasoconstriction and raises mean arterial pressure, making vasopressin a rational agent for vasodilatory shock states including septic shock (PMID 16088512). The V1b (also called V3) receptor is expressed in the anterior pituitary and modulates ACTH release and stress-related behavior (PMID 33477721). The V2 receptor on renal collecting duct cells mediates water reabsorption via aquaporin-2 upregulation, underpinning vasopressin's classical antidiuretic function, and activation of this receptor also stimulates cyclic AMP production (PMID 36752971). In septic shock, endogenous vasopressin levels are often paradoxically low relative to the severity of hypotension, creating a physiologic deficiency that exogenous vasopressin replacement can correct (PMID 16088512, 38402511). At replacement doses (0.01–0.04 units/min IV), vasopressin restores vascular tone without the tachyphylaxis associated with catecholamines. A 2023 narrative review found that vasopressin initiated at lower norepinephrine-equivalent doses was associated with improved mortality, suggesting timing of initiation matters (PMID 37479058). Beyond the vascular system, vasopressin exerts complex cardiac effects including direct influence on coronary vasculature and myocardial contractility (PMID 24621650), and centrally acts as a neurohormone involved in social behavior, parental bonding, and stress responses (PMID 33477721). Excess vasopressin secretion can contribute to pathological brain edema via V1a and V2 receptor-mediated fluid accumulation in stroke, traumatic brain injury, and other neurological conditions (PMID 32138953). Vasopressin's short plasma half-life of 10–35 minutes necessitates continuous IV infusion in acute care settings (PMID 26154286). Its precursor peptide copeptin is released in equimolar amounts and serves as a more stable surrogate biomarker for vasopressin secretion in endocrine diagnostics including differentiation of central diabetes insipidus from other polyuric disorders (PMID 37859988).

Class: Endogenous nonapeptide hormone; posterior pituitary hormone; vasopressor; antidiuretic agent

Administration & storage

Administration
Continuous intravenous infusion via central or peripheral vein (primary route in shock)Subcutaneous injection for diabetes insipidus management (aqueous vasopressin5–10 units)Intramuscular injection for diabetes insipidusIntra-arterial administration has been used for control of gastrointestinal hemorrhage (vasopressin infusion into mesenteric artery) — specialty use only
Storage
Store vasopressin injection at 20–25°C (68–77°F); excursions permitted to 15–30°C. Do not freeze. Protect from light. Discard unused portions of single-dose vials. Diluted solutions for IV infusion should be used within 18 hours at room temperature or 24 hours under refrigeration.
Cautions
Ischemic complications: vasopressin causes potent vasoconstriction; doses above 0.04 units/min in septic shock are associated with increased risk of digital, mesenteric, and myocardial ischemia (PMID 38402511).,Cardiac effects are complex: vasopressin can cause coronary vasoconstriction at higher doses and has variable effects on cardiac contractility depending on dose and baseline state; use with caution in active coronary artery disease (PMID 24621650, 27788216).,Hyponatremia: V2 receptor-mediated water retention can cause dilutional hyponatremia, particularly if vasopressin is given with hypotonic fluids or in excess of physiological need (PMID 32138953).,Brain edema: excess vasopressin secretion or exogenous administration in the setting of neurological injury (stroke, TBI, subarachnoid hemorrhage) may worsen cerebral edema via V1a and V2 receptor mechanisms (PMID 32138953).,Abdominal cramping and nausea: vasopressin can stimulate smooth muscle contraction in the GI tract, causing abdominal cramping, passage of gas, or nausea — especially with SC injection for DI.,Pregnancy (Category C): vasopressin can stimulate uterine contractions at pharmacological doses; use only when clearly needed during pregnancy.

Legal & regulatory status

US FDA

FDA-approved in two forms: (1) Vasostrict (vasopressin injection, 20 units/mL) — approved for increasing blood pressure in adults with vasodilatory shock (e.g., post-cardiotomy shock or septic shock) who remain…

WADA

Vasopressin is not listed on the WADA Prohibited List for sports doping. It is a hospital-dispensed, medically necessary peptide hormone with no established performance-enhancing role in healthy athletes. However, its…

Health Canada

Vasopressin injection is available in Canada as a prescription drug for central diabetes insipidus and as a vasopressor adjunct in vasodilatory shock. It is listed in the Health Canada Drug Product Database and used per…