Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Pituitary hormone - Antidiuretic agent
Original Date: 
February 2011
Revised Date: 
Feb 2024
  • Refractory hypotension unresponsive to exogenous catecholamines
  • May be considered for Persistent Pulmonary Hypertension of the Newborn refractory to inhaled Nitric Oxide
  • IV continuous infusion (central line preferred)

Usual dosage range: 0.0003 to 0.002 units/kg/minute


Side Effects: 
  • CVS: hypertension, bradycardia, vasoconstriction
  • Endocrine and metabolic: hyponatremia with water retention
  • Hematologic: hypercoagulation -e.g. venous thrombosis
  • Hepatic: splanchnic hypoperfusion is a potential complication
  • Local: tissue necrosis due to extravasation into subcutaneous tissues
  • Renal: decreased urine output, decreased renal perfusion
Parameters to Monitor: 

NOTE: Judicious fluid management and frequent monitoring of electrolytes is required with treatment

  • BP, HR
  • Serum electrolytes especially Na
  • Serum and urine osmolality
  • Urine output, total fluid intake/output
  • Renal perfusion: serum creatinine, BUN
  • Peripheral perfusion: body temperature, capillary refill, peripheral pulses, skin pallor, serum lactate
  • Hepatic markers: transaminases, bilirubin
  • Platelet count, hemoglobin, hematocrit
Reconstitution and Stability: 


  • Vasopressin 20 units/mL
    • Take 0.05 mL (1 unit) and add to 49.95 mL of 0.9 % NaCl
    • Final concentration: 0.02 units/mL
  • Vasopressin 20 units/mL
    • Take 0.4 mL (8 units) and add to 19.6 mL of 0.9% NaCl
    • Final concentration: 0.4 units/mL
  • Vasopressin 20 units/mL
    • Take 1 mL (20 units) and add to 19 mL of 0.9% NaCl
    • Final concentration: 1 unit/mL


  • Vasopressin 20 units/mL
    • Take 0.05 mL (1 unit) and add to 19.95 mL of D5W
    • Final concentration: 0.05 unit/mL
  • Vasopressin 20 units/mL
    • Take 0.2 mL (4 units) and add to 19.8 mL of D5W
    • Final concentration: 0.2 unit/mL

- Solutions Compatible: D5W, 0.9% NaCl

- Y-site Compatible: dobutamine, dopamine, epinephrine, fluconazole, heparin, insulin, norepinephrine, phenylephrine

Incompatible: furosemide


- Mohamed A, Nasef N, Shah V, McNamara PJ.  Vasopressin as a Rescue Therapy for Refractory Pulmonary Hypertension in Neonates: Case Series. Pediatr Crit care Med 2014; 15: 148-154

- Bidegain M, Greenberg R, Simmons C, et al.  Vasopressin for Refractory Hypotension in Extremely Low Birth Weight Infants.  J Pediatr 2010; 157: 502-4

- Trissel LA. Handbook on Injectable Drugs. 16th Edition. Bethesda: American Society of Health-System Pharmacists; 2011

- Evidence-based Practice for Improving Quality  (EPIQ) Recommendations on Hemodynamics, 2023

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