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Health Sciences Authority
Dear Healthcare Professional Letters

GLYPRESSIN ® (Terlipressin): Serious or fatal respiratory failure and sepsis/septic shock in patients with type 1 hepatorenal syndrome

Audiences

Healthcare professional

Industry member

Product type

Therapeutic Products

21 April 2023

This article has been migrated from an earlier version of the site and may display formatting inconsistencies.

A Dear Healthcare Professional Letter has been issued by FERRING Pharmaceuticals Pte Ltd to inform healthcare professionals of new safety updates regarding the use of terlipressin in patients with type 1 hepatorenal syndrome (type 1 HRS), based on results from the CONFIRM trial. Terlipressin may cause serious or fatal respiratory failure at a frequency higher than previously known in these patients and may increase their risk of sepsis/septic shock. Terlipressin should be avoided in patients with advanced renal dysfunction [baseline serum creatinine ≥ 442 µmol/L (5.0mg/dL)] and those with Acute-on-Chronic Liver Failure (ACLF) grade 3 and / or Model for End-Stage Liver Disease (MELD) score ≥ 39, unless the benefit outweighs the risks. Patients with new onset of breathing difficulties or worsening of existing respiratory disease should be stabilised prior to administering the first dose of terlipressin, with close monitoring during treatment. Patients should also be monitored for signs and symptoms of infection. The Singapore package insert for Glypressin® is being updated to add continuous intravenous (IV) infusion as a method of administration since this method may be associated with lower rates of severe adverse events as compared with IV bolus administration. Please refer to the letter for details.

Only abstracts of the Dear Healthcare Professional Letters (DHCPL) are provided on this website. Details of these letters can be found in the MOH Alert System, which is accessible via the Health Professionals Portal (HPP), a one-stop portal for all healthcare professionals in Singapore. Dentists, medical doctors and pharmacists may access HPP at https://hpp.moh.gov.sg and follow the procedures below to access the MOH Alert system.

Step 1: Select your profession under ‘For Healthcare Professionals’.

Step 2: Click on ‘Useful links’.

Step 3: Click on ‘MOH Alert’ and log in via Singpass.

Step 4: Click on ‘Drug Alerts’ or ‘Med Device Alerts’ to view the DHCPLs.

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