Rawn Salenger, MD
Associate Professor of Surgery
University of Maryland School of Medicine, Baltimore, MD
Traditional vasopressors can leave patients
stranded with dangerous hypotension.1
REACH FOR
GIAPREZA SOONER
Pull more patients up to target MAP
with a RAAS
pathway approach2
achieved and sustained target MAP
when GIAPREZA was added to
traditional vasopressors (70% vs 23%)
in a phase 3 trial of 321 patients with vasodilatory (distributive) shock who remained hypotensive despite fluid and vasopressor therapy.1,3
THE ROLE OF RAAS
Target a vasoregulatory system
that traditional vasopressors miss1,4-9
See how GIAPREZA worksSurvival benefit
was greatest
with early use of GIAPREZA
in an exploratory post hoc analysis of ATHOS-3, based on improved survival when GIAPREZA was used with lower doses of traditional vasopressors.10
Learn moreCritical Views:
Leading voices in vasodilatory shock
Samir S. Awad, MD, MPH, FACS
Chief of Surgery and Medical Director Surgical Intensive Care Unit
Michael E. DeBakey VA Medical Center, Houston, TX
Richard G. Wunderink, MD, MS
Professor of Medicine, Pulmonary and Critical Care
Northwestern University Feinberg
School of Medicine, Chicago, IL
David W. Boldt, MD, MS
Chief, Division of Trauma and Adult Multi-Specialty Anesthesiology
University of California,
Los Angeles, CA
Connect with a GIAPREZA sales
REP FOR INFO
and support.
ATHOS-3=Angiotensin II for the Treatment of High-Output Shock; MAP=mean arterial pressure; RAAS=renin-angiotensin-aldosterone system.
References:
- GIAPREZA. Prescribing information. La Jolla Pharmaceutical Company; 2021.
- Vincent J-L, Nielsen ND, Shapiro NI, et al. Mean arterial pressure and mortality in patients with distributive shock: a retrospective analysis of the MIMIC-III database. Ann Intensive Care. 2018;8(1):107. doi:10.1186/s13613-018-0448-9
- Khanna A, English SW, Wang XS, et al. Angiotensin II for the treatment of vasodilatory shock. N Engl J Med. 2017;377(5):419-430. doi:10.1056/NEJMoa1704154
- Klijian A, Khanna AK, Reddy VS, et al. Treatment with angiotensin II is associated with rapid blood pressure response and vasopressor sparing in patients with vasoplegia after cardiac surgery: a post-hoc analysis of Angiotensin II for the Treatment of High-Output Shock (ATHOS-3) study. J Cardiothorac Vasc Anesth. 2021;35(1):51-58. doi:10.1053/j.jvca.2020.08.001
- Demiselle J, Fage N, Radermacher P, et al. Vasopressin and its analogues in shock states: a review. Ann Intensive Care. 2020;10(1):9. doi:10.1186/s13613-020-0628-2
- National Center for Biotechnology Information. PubChem Compound Summary for CID 172198, angiotensin II. Accessed August 21, 2026. https://pubchem.ncbi.nlm.nih.gov/compound/Angiotensin-II-human
- Khalil B, Rosani A, Warrington SJ. Physiology, Catecholamines. StatPearls; 2024. Accessed August 21, 2026. https://www.ncbi.nlm.nih.gov/books/NBK507716/
- Richards E, Lopez MJ, Maani CV. Phenylephrine. In: StatPearls. StatPearls Publishing; updated October 30, 2023. Accessed June 10, 2026. https://www.ncbi.nlm.nih.gov/books/NBK534801/
- Ashkar H, Adnan G, Patel P, et al. Dobutamine. In: StatPearls. StatPearls Publishing; updated February 23, 2024. Accessed June 10, 2026. https://www.ncbi.nlm.nih.gov/books/NBK470431/
- Wieruszewski PM, Bellomo R, Busse LW, et al. Initiating angiotensin II at lower vasopressor doses in vasodilatory shock: an exploratory post-hoc analysis of the ATHOS-3 clinical trial. Crit Care. 2023;27(1):175. doi:10.1186/s13054-023-04446-1
INDICATION
GIAPREZA® (angiotensin II) increases blood pressure in adults with septic or other distributive shock.
IMPORTANT SAFETY INFORMATION
Warnings and Precautions
The safety of GIAPREZA was evaluated in 321 adults with septic or other distributive shock in a randomized, double-blind, placebo-controlled study, ATHOS-3. There was a higher incidence of arterial and venous thrombotic and thromboembolic events in patients who received GIAPREZA compared to placebo-treated patients in the ATHOS-3 study (13% vs. 5%). The major imbalance was in deep venous thromboses. Use concurrent venous thromboembolism (VTE) prophylaxis.
Adverse Reactions
The most common adverse reactions reported in greater than 10% of GIAPREZA-treated patients were thromboembolic events. Adverse reactions occurring in ≥4% of patients treated with GIAPREZA and ≥1.5% more often than placebo-treated patients in the ATHOS-3 study were thromboembolic events (including deep vein thrombosis), thrombocytopenia, tachycardia, fungal infection, delirium, acidosis, hyperglycemia, and peripheral ischemia.
Drug Interactions
Angiotensin converting enzyme (ACE) inhibitors may increase response to GIAPREZA. Angiotensin II receptor blockers (ARBs) may reduce response to GIAPREZA.
You are encouraged to report negative side effects of prescription drugs to the FDA. To report SUSPECTED ADVERSE REACTIONS, please contact:
Before administering, please see the Full Prescribing Information for GIAPREZA.