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Terlipressin Linked to Sodium Reduction in Bleeding Patients

Last Updated: September 28, 2010.

Patients with severe portal-hypertensive bleeding who are treated with terlipressin commonly have an acute reduction in serum sodium concentration that is associated with neurological complications and is usually reversible after the treatment is ended, according to research published in the October issue of Hepatology.

TUESDAY, Sept. 28 (HealthDay News) -- Patients with severe portal-hypertensive bleeding who are treated with terlipressin commonly have an acute reduction in serum sodium concentration that is associated with neurological complications and is usually reversible after the treatment is ended, according to research published in the October issue of Hepatology.

Elsa Sola, of the University of Barcelona in Spain, and colleagues analyzed outcomes of 58 patients with gastrointestinal bleeding due to portal hypertension who were treated with terlipressin.

The researchers found that, overall, serum sodium fell from 134.9 to 130.5 mEq/L. In 36 percent of patients the decrease was greater than 10 mEq/L, in 31 percent it was between 5 and 10 mEq/L, and in 67 percent it was 5 mEq/L or greater. Patients with low Model for End-stage Liver Disease score and baseline serum sodium that was normal or nearly so had the highest hyponatremia risk. In most patients, serum sodium returned to baseline soon after ending the treatment. Three of the 21 patients with a marked reduction had neurological manifestations.

"Although the acute changes in serum sodium concentration are rapidly reversible after terlipressin withdrawal, the results of our study suggest that serum sodium levels should be monitored daily in patients receiving terlipressin for acute gastrointestinal bleeding due to portal hypertension, and treatment with terlipressin stopped if serum sodium decreases around 10 mEq/L. Neurological status should be checked in patients developing severe reduction in serum sodium," the authors conclude.

A co-author disclosed financial relationships with Ferring, Astellas, and Chiasma; another co-author disclosed a relationship with Ferring.

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