Angiotensin II
Vasoactive Peptide HormoneapprovedAlso known as: Ang II, Giapreza, Hypertensin
An 8-amino acid endogenous peptide hormone central to the renin-angiotensin-aldosterone system (RAAS), mediating vasoconstriction, aldosterone release, and blood pressure regulation.
Overview
Angiotensin II is an octapeptide generated by the enzymatic cleavage of angiotensin I by angiotensin-converting enzyme (ACE). It is the primary effector of the renin-angiotensin-aldosterone system and one of the most potent vasoconstrictors in the body. Synthetic angiotensin II (brand name Giapreza) was FDA-approved in 2017 for the treatment of refractory vasodilatory shock. Beyond blood pressure regulation, angiotensin II plays roles in inflammation, fibrosis, oxidative stress, and cellular growth. The entire pharmaceutical class of ACE inhibitors and angiotensin receptor blockers (ARBs) was developed to counteract its effects in hypertension and heart failure.
Mechanism of Action
Angiotensin II acts primarily through AT1 and AT2 receptors: (1) AT1 receptor activation causes potent arteriolar vasoconstriction; (2) Stimulates aldosterone secretion from the adrenal cortex, increasing sodium and water retention; (3) Enhances sympathetic nervous system activity; (4) Promotes ADH (vasopressin) release from the posterior pituitary; (5) Stimulates thirst through central nervous system actions; (6) AT2 receptor activation mediates counterregulatory vasodilation, anti-inflammatory, and anti-fibrotic effects; (7) Promotes cardiac and vascular remodeling through growth factor stimulation.
Molecular Formula
C50H71N13O12
Molecular Weight
1046.18 g/mol
Sequence
Asp-Arg-Val-Tyr-Ile-His-Pro-Phe
Dosage Protocols
Dose Range
20 ng/kg/min – 80 ng/kg/min
Frequency
Continuous IV infusion
Route
intravenous
Cycle Length
Until hemodynamic stability
Start at 20 ng/kg/min, titrate every 5 minutes as needed. Maximum recommended dose 80 ng/kg/min during first 3 hours, then taper to ≤40 ng/kg/min. Use with other vasopressors.
Source: Giapreza FDA prescribing information
🧮 Personalized Dosage Calculator
💰 Estimated Pricing
Typical Supply
2.5mg vial
Last Updated
2026-02
Brand Giapreza for vasodilatory shock. Hospital/pharmacy pricing only. Not used outside clinical settings.
⚠️ Prices are estimates based on publicly available data and may vary significantly by vendor, location, and prescription status. This is not medical or financial advice.
Side Effects
| Effect | Severity |
|---|---|
| Thromboembolic events | severe |
| Tachycardia | moderate |
| Peripheral ischemia | severe |
| Hyperglycemia | mild |
| Acidosis | moderate |
Pros & Cons
Effective rescue vasopressor when catecholamines fail in refractory shock
Works through a distinct receptor pathway (AT1) independent of adrenergic receptors
Rapid onset of action with titratable blood pressure response
Significant risk of thromboembolic events (13% in trials)
Risk of peripheral and organ ischemia from excessive vasoconstriction
Limited to ICU use for vasodilatory shock — not a general-purpose peptide
Research Studies
🩸 Blood Work
No specific bloodwork requirements reported for this peptide. General health panels are always recommended before starting any peptide protocol.
Legal Status
FDA-approved as Giapreza for vasodilatory shock (2017). Prescription-only, hospital/ICU use. The body naturally produces angiotensin II as part of the RAAS.
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