AHFS Class:

68:44 Renin-Angiotensin-Aldosterone System (RAAS)

Generic Name

• Angiotensin II Acetate

Angiotensin II acetate concentrate for injection is available as a solution in 1-mL single-dose vials with each mL containing the equivalent of 2.5 mg angiotensin II.³³⁹⁷ Each mL of solution also contains mannitol 25 mg and sodium hydroxide and/or hydrochloric acid for pH adjustment in water for injection.³³⁹⁷

Angiotensin II acetate concentrate for injection must be diluted in sodium chloride 0.9% prior to administration.³³⁹⁷ For fluid-restricted patients, 1 mL (2.5 mg) or 2 mL (5 mg) of the concentrate for injection should be diluted in a 250- or 500-mL infusion bag, respectively, of sodium chloride 0.9% for a resulting concentration of 10,000 ng/mL.³³⁹⁷ For patients who are not fluid restricted, 1 mL (2.5 mg) of the concentrate for injection should be diluted in a 500-mL infusion bag of sodium chloride 0.9% for a resulting concentration of 5000 ng/mL.³³⁹⁷

pH

Adjusted to 5.5.³³⁹⁷

Osmolality

When diluted as directed in sodium chloride 0.9%, the diluted solution of angiotensin II will assume the same osmolality as the sodium chloride 0.9% solution.³⁴³⁰

Equivalency

Angiotensin II 2.5 mg is equivalent to an average of 2.9 mg of angiotensin II acetate.³³⁹⁷

Trade Name(s)

Giapreza

Angiotensin II acetate is administered as a continuous intravenous infusion following dilution in sodium chloride 0.9%.³³⁹⁷ The manufacturer recommends administration of the infusion through a central venous line,³³⁹⁷ preferably through a dedicated port.³⁴³⁰

Infusion of the diluted angiotensin II solution should be initiated at a rate of 20 ng/kg/min with an upward titration as frequently as every 5 minutes by increments of up to 15 ng/kg/min as needed to achieve or maintain target blood pressure.³³⁹⁷ The infusion rate should not exceed 80 ng/kg/min during the first 3 hours of treatment; the maintenance infusion rate should not exceed 40 ng/kg/min.³³⁹⁷

Angiotensin II acetate concentrate for injection is a clear solution.³³⁹⁷ Intact vials of the concentrate for injection should be stored under refrigeration at 2 to 8°C.³³⁹⁷ Angiotensin II acetate solutions should be visually inspected for particulate matter and discoloration prior to administration.³³⁹⁷

Diluted solutions of angiotensin II for infusion may be stored at room temperature or under refrigeration for up to 24 hours; after this period, the diluted solutions should be discarded.³³⁹⁷

Sorption

Both polyvinyl chloride (PVC) and non-PVC infusion bags containing sodium chloride 0.9% may be used in the preparation of angiotensin II for infusion.³⁴³⁰ Adherence of the peptide to the infusion bag has not been observed in compatibility studies.³⁴³⁰

Solution Compatibility

Y-Site Injection Compatibility (1:1 Mixture)

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions September 30, 2019. © Copyright, 2024. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.