angiotensin II


an-jee-oh-ten-sin too

Trade Name(s)

  • Giapreza

Ther. Class.

Pharm. Class.


Increases blood pressure in septic or other distributive shock.


Causes vasoconstriction and release of aldosterone, which lead to an increase in blood pressure.

Therapeutic Effect(s):

Increase in mean arterial pressure.


Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism and Excretion: Metabolized by aminopeptidase A and angiotensin converting enzyme 2 to angiotensin-(2-8) [angiotensin III] and angiotensin-(1-7), respectively in plasma, erythrocytes and many major organs.

Half-life: <1 min.

TIME/ACTION PROFILE (increase in mean arterial pressure)

IVminutes5 minminutes


Contraindicated in:

  • None.

Use Cautiously in:

  • OB:  Use only if potential maternal benefit outweighs potential fetal risk
  • Lactation: Safety not established;
  • Pedi:  Safety and effectiveness in children not established.

Adverse Reactions/Side Effects

CNS: delirium

CV: THROMBOEMBOLIC EVENTS, peripheral ischemia, tachycardia

Endo: hyperglycemia

Hemat: thrombocytopenia

Misc: fungal infection

* CAPITALS indicate life-threatening.
Underline indicate most frequent.



  • Concurrent use with  ACE inhibitors  may ↑ vasopressor effects.
  • Concurrent use with  angiotensin receptor blockers  may ↓ vasopressor effects.


IV (Adults): 20 ng/kg/min continuous infusion; may be titrated every 5 min of up to 15 ng/kg/min to achieve or maintain target mean arterial pressure. Do not exceed dose of 80 ng/kg/min during first 3 hr. During maintenance therapy, do not exceed dose of 40 ng/kg/min. Once shock has adequately improved, titrate down by 15 ng/kg/min every 5–15 min based on mean arterial pressure.


Solution for IV infusion (must be diluted): 2.5 mg/mL


  • Monitor blood pressure continuously or frequently during therapy.
  • Monitor for deep venous thromboses. Use concurrent venous thromboembolism (VTE) prophylaxis (TED stockings, hydration) during therapy.

Potential Diagnoses


  • Rate: Administer based on rate in Route/Dosage. After sufficient improvement in underlying shock, down-titrate every 5–15 min by increments of up to 15 ng/kg/min based on blood pressure.

IV Administration

Continuous Infusion:   Diluent:  Dilute vial of angiotensin II in 250 ml for fluid restriction or 500 ml of 0.9% NaCl. Concentration: 5,000 ng/mL or 10,000 ng/mL.Store at room temperature or refrigerated for up to 24 hrs. Discard unused portion of vial or diluted solution after 24 hrs. Administer through central line.

Patient/Family Teaching

  • Educate patient on purpose of angiotensin II.
  • Advise female patient to notify health care profession if pregnant.

Evaluation/Desired Outcomes

Increase in mean arterial pressure.

angiotensin II is a sample topic from the Davis's Drug Guide.

To view other topics, please or .

Pediatrics Central™ is an all-in-one application that puts valuable medical information, via your mobile device or the web, in the hands of clinicians treating infants, children, and adolescents. .