Angiotensin II
Angiotensin II dosing, mechanism of action, side effects, and clinical evidence. Complete reference for healthcare professionals.
MetabolicIntravenous (Giapreza)20ng/kg/min IV, titrate
Overview
Angiotensin II (Giapreza) is a synthetic form of angiotensin II FDA-approved for raising blood pressure in adults with distributive shock.
Mechanism of Action
- AT1R agonism — Potent vasoconstriction via angiotensin II type 1 receptors
- Aldosterone release — Stimulates adrenal aldosterone secretion
- Blood pressure — Raises mean arterial pressure in vasodilatory shock
- Sympathetic potentiation — Enhances norepinephrine release
Dosing
Initial: 20ng/kg/min IV infusion. Titrate by 15ng/kg/min q5min to target MAP. Max: 80ng/kg/min.
Safety
FDA-approved (2017). Risk of thrombosis — concurrent DVT prophylaxis required. Monitor for infection.
Last updated: 2026-03-27