Category · 25 entries
Cardiovascular & Renal
Vasopressors, vasopressin analogs, natriuretic peptides, antithrombotic peptides, and related cardiovascular/renal agents.
Adrenomedullin
A 52-amino-acid vasodilator hormone discovered in 1993, infused in small trials for pulmonary hypertension, ulcerative colitis and Crohn's disease; the bowel-disease trials missed their primary end points. Not approved.
Angiotensin II
The body's blood-pressure hormone as an ICU drug: Giapreza raised pressure in seven of ten patients in shock; survival did not significantly change.
ANP
The heart's salt-excreting hormone: sold in Japan as carperitide since 1995, while US kidney trials of anaritide found no benefit.
Apelin
The natural ligand of the APJ receptor, discovered in 1998: in short human infusion studies it widened arteries through nitric oxide and, in kidney disease, lowered blood pressure and raised kidney blood flow. A research peptide; no apelin drug is approved.
Bivalirudin
Angiomax — the workhorse direct thrombin inhibitor for percutaneous coronary intervention. FDA-approved December 2000 (The Medicines Company, now Sandoz); the first synthetic peptide DTI to achieve broad PCI adoption. REPLACE-2, ACUITY, and HORIZONS-AMI trials established the anticoagulant profile; subsequent MATRIX trial outcomes shifted practice in some populations back toward heparin.
BNP
The hormone a stretched heart releases: a standard blood test for heart failure since 2000, and the discontinued drug nesiritide.
Bradykinin
The peptide behind wheals, leaky vessels and asthma narrowing; never a treatment, but its B2 blocker icatibant treats angioedema attacks.
Carperitide
⚠ Approved in Japan only (1995). Recombinant human ANP infused for acute heart failure and used in more than half of Japanese admissions in one study, but its outcome evidence conflicts: a propensity-matched analysis linked it to higher in-hospital mortality, and its randomised LASCAR-AHF trial stopped early without showing benefit.
CGRP
The vasodilating neuropeptide behind migraine attacks: infused, it triggers them, and drugs that block it now prevent them.
CNP
The third natriuretic peptide — a vascular and skeletal growth factor whose analog vosoritide (Voxzogo) is FDA-approved for achondroplasia, and the endogenous cartilage growth signal.
Danegaptide
A dipeptide that keeps heart and brain cells coupled through connexin-43: it shrank infarcts in pigs, failed in a 585-patient heart attack trial, and has moved to diabetic eye disease.
Desmopressin
DDAVP — the classic V2-selective vasopressin analog. FDA-approved February 1978 for central diabetes insipidus; decades of label expansion added primary nocturnal enuresis, nocturia (Noctiva / Nocdurna), and hemostatic use in mild hemophilia A and type 1 von Willebrand disease. WHO Essential Medicines List.
Endothelin-1
One of the body's most potent vessel constrictors: a drug target for pulmonary hypertension, given to people only in experiments.
Enlicitide
Merck's oral macrocyclic peptide PCSK9 inhibitor, approved by FDA as Lipfendra on July 15, 2026: one 20 mg tablet a day cut LDL cholesterol by about 56% more than placebo in its phase 3 trial.
Eptifibatide
A cyclic heptapeptide that blocks platelet glycoprotein IIb/IIIa, modelled on barbourin from the venom of the southeastern pigmy rattlesnake. FDA-approved as Integrilin on May 18, 1998 for acute coronary syndromes and coronary intervention; now sold as generics.
Erythropoietin (EPO)
A glycoprotein hormone that drives red blood cell production; recombinant forms are FDA-approved standards of care for anemia of chronic kidney disease and chemotherapy-induced anemia, and have a notorious history of misuse in endurance sport.
Felypressin
The vasopressin analogue added to prilocaine dental anaesthetics instead of adrenaline, approved widely abroad and never in the US.
Goralatide
The body's own stem-cell brake, freed from thymosin beta-4 and cleared by ACE: a chemotherapy-protection trial in 1995 found no benefit, and its antifibrotic promise remains in animals.
Icatibant
The bradykinin blocker for angioedema — a synthetic decapeptide B2 receptor antagonist that stops acute swelling attacks within 30 minutes.
Lixivaptan
An oral vasopressin V2 blocker, not a peptide, that raised sodium in hyponatraemia trials and was discontinued in June 2022.
Nesiritide
Recombinant human B-type natriuretic peptide, sold in the US as Natrecor for acute heart failure. In the 7,141-patient ASCEND-HF trial it did not change death or readmission and had only a small, non-significant effect on breathlessness; Drugs@FDA lists Natrecor as discontinued.
Selepressin
A selective vasopressin V1A agonist that cut norepinephrine needs in septic shock, then failed to improve outcomes in an 828-patient adaptive trial stopped for futility.
Terlipressin
Terlivaz — the first and only FDA-approved drug for hepatorenal syndrome (HRS). FDA-approved September 2022 (Mallinckrodt) for adults with HRS with rapid reduction in kidney function, after a multi-decade regulatory history including four prior Complete Response Letters and the successful CONFIRM Phase 3 trial (NEJM 2021).
Ularitide
⚠ Phase 3 failure. Cardiorentis's ularitide, a synthetic copy of the kidney's natriuretic peptide urodilatin, lowered cardiac filling pressures in phase 2, but TRUE-AHF (NEJM 2017, n=2,157) found no effect on cardiovascular death or on the early clinical course. Never approved.
Vasopressin
The antidiuretic hormone as an ICU vasopressor (Vasostrict, 2014): added to norepinephrine in shock, it was safe but did not lower mortality in VASST or pooled trials, did better after cardiac surgery, and its price rose steeply after a 2014 rebranding.