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Initiate

Recommended starting dose of GIAPREZA is 20 ng/kg/min, which is equivalent to 0.02 mcg/kg/min, via continuous intravenous infusion1

  • Dosage is measured in NANOGRAMS (ng), not micrograms (mcg)

Assess

In the ATHOS-3 trial, the median response time for GIAPREZA responders was approximately 5 minutes1a

  • Monitor blood pressure closely after GIAPREZA initiation
  • In the ATHOS-3 trial, the median dose of GIAPREZA was 10 ng/kg/min at 30 minutes

Optimize

Titrate GIAPREZA to effect in each patient1

  • Titrate every 5 minutes by increments of up to 15 ng/kg/min
  • During the first 3 hours, the maximum dose should not exceed 80 ng/kg/min. Maintenance dose should not exceed 40 ng/kg/min
  • Once the underlying shock has sufficiently improved, down-titrate every 5 to 15 minutes in increments of up to 15 ng/kg/min based on blood pressure
    • Half-life of GIAPREZA is less than 1 minute

Preparing GIAPREZA

  • Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.1

  • GIAPREZA must be administered as an intravenous infusion. Dilute 1 mL of GIAPREZA in 0.9% saline to achieve a final concentration of 5000 ng/mL or 10000 ng/mL.1

  • Discard vial and any unused portion of the drug product after use.1

GIAPREZA (angiotensin II) central line infusion rate tool

Use this 2-step tool to find infusion rates for a range of GIAPREZA doses

GIAPREZA infusion rate results (250 mL) (500 mL)

250 mL infusion bag HIGH CONCENTRATION

500 mL infusion bag STANDARD CONCENTRATION

Step 1

Select infusion
bag size

  • 250 mL infusion bag

    HIGH CONCENTRATION
    (10000 ng/mL of GIAPREZA)

  • 500 mL infusion bag

    STANDARD CONCENTRATION
    (5000 ng/mL of GIAPREZA)

Step 2

Select the patient’s weight
(30 kg-230 kg)

Review important GIAPREZA dosing information

IMPORTANT: Dilute GIAPREZA in 0.9% saline solution before use. One mL of GIAPREZA can be mixed in 2 different infusion bag sizes corresponding to 2 different GIAPREZA concentrations:1

  • 250 mL (10000 ng/mL of GIAPREZA [HIGH CONCENTRATION])
  • 500 mL (5000 ng/mL of GIAPREZA [STANDARD CONCENTRATION])
  • The 250 mL bag may be used for fluid-restricted patients.

What to know when initiating GIAPREZA

  • Central venous line administration is recommended1
  • Monitor blood pressure response and titrate GIAPREZA every 5 minutes by increments of up to 15 ng/kg/min, as needed, to achieve or maintain target blood pressure1
    • The plasma half-life of IV-administered GIAPREZA is less than 1 minute, which allows for individualized dose adjustment
  • Once the underlying shock has sufficiently improved, down-titrate every 5 to 15 minutes by increments of up to 15 ng/kg/min based on blood pressure1
  • Use concurrent venous thromboembolism (VTE) prophylaxis1


DISCLAIMER: By using this resource, you agree to the following: this Web Tool is being provided “AS IS” and is intended as a tool and an aid for licensed and qualified healthcare providers. At all times, the treating healthcare provider shall use his/her medical professional judgment and opinion in treating the patient. This tool is a resource and does not provide any clinical guidance or advice about the particular patient or his/her treatment. All outputs should be confirmed before use. La Jolla Pharmaceutical Company makes no claims as to the accuracy of the information contained herein. Neither La Jolla Pharmaceutical Company, nor any other party involved in the preparation or publication of this site, shall be liable to you or others for any treatment decisions made or actions taken by you or others in reliance on this information.

Additional Dosing Tools

Important Safety Information See more

Warnings and Precautions The safety of GIAPREZA was evaluated in 321 adults with septic or other distributive shock in the randomized, double-blind, placebo-controlled ATHOS-3 study. 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% (21/163 patients) vs. 5% (8/158 patients)]. The major imbalance was in deep venous thromboses. Use concurrent venous thromboembolism prophylaxis.

IndicationGIAPREZA™ (angiotensin II) increases blood pressure in adults with septic or other distributive shock.

Important Safety Information

Indication GIAPREZA™ (angiotensin II) increases blood pressure in adults with septic or other distributive shock.

Contraindications None.

Warnings and Precautions The safety of GIAPREZA was evaluated in 321 adults with septic or other distributive shock in the randomized, double-blind, placebo-controlled ATHOS-3 study. 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% (21/163 patients) vs. 5% (8/158 patients)]. The major imbalance was in deep venous thromboses. Use concurrent venous thromboembolism 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 inhibitors may increase response to GIAPREZA.

Angiotensin II receptor blockers may reduce response to GIAPREZA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional Important Safety Information, please see the full Prescribing Information.

Reference: GIAPREZA™ (angiotensin II) [prescribing information]. San Diego, CA: La Jolla Pharmaceutical Company; 2017.

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