Angiotensin II dosage and evidence
Written by Aaron CuhaReviewed Sep 2026
The short answer
Angiotensin II is the body's main hormone for raising blood pressure.
Evidence grade for Angiotensin II: Moderate. The rule: at least one finished study in people, and at least 100 people who took it. The sum on this page: 1 completed trial, 344 people given it. A grade counts how much has been done to people, not whether it works.
- People given it
- 344
- Human studies
- 1
- Found nothing
- 0
Dose
Approved medicine. No human dose established for unlabelled uses
Labeled amounts sit on the prescribing information. This page records what trials measured, not a personal dose.
FDA approved 21 December 2017 (GIAPREZA, NDA 209360) to raise blood pressure in adults in shock from a severe infection (septic shock) or other shock where the blood vessels open too wide. Prescription only, given by drip into a vein. A generic angiotensin II acetate injection was approved 3 June 2025 (ANDA 216966).
3 effects reported, 2 unwanted, 1 wanted, by people using it, not a trial
Goal pages: Ageing and longevity
In plain English
In plain English, from Aaron
This is how I would explain it to a friend. The evidence, with the numbers, is further down the page.
Angiotensin II is your body's main hormone for raising blood pressure. Most blood pressure pills work by blocking it. As a drug, it is a drip used in intensive care. It is for shock, when blood pressure will not hold on other drugs.
What people take it for
- Doctors use it to raise blood pressure in shock.
- It shows up in peptide lists, but nobody takes it outside a hospital.
What studies in people showed
In the main study, 344 very sick adults got angiotensin II or a dummy drip. Blood pressure rose by hour 3 in 69.9 percent on the drug, against 23.4 percent on the dummy drip. By day 28, 46 percent had died on the drug and 54 percent on the dummy drip. That gap could be chance. In one hospital's records, 147 patients on 3 or more blood pressure drugs did worse on it. But the sickest patients got it, so that is not a fair test.
What people report
Reports, not study results
The good
- In the main study, blood pressure came up in most patients when other drugs had failed.
The bad
- Serious problems hit 60.7 percent on the drug and 67.1 percent on the dummy drip. These were very sick people.
- It has not been shown to save lives.
Where these come from: No user reports. These come from the ATHOS-3 study of 344 patients and the hospital records on this page.
My bottom line
This is an ICU drug, full stop. If you care about this hormone, check your blood pressure. That is the number it moves.
An opinion, not a finding. I am a coach, not a doctor.
What it has been measured to do
Measured in people
Goals Angiotensin II has been tested for in people, biggest studies first. We count only what the studies on this page say, so the real numbers may be higher.
- Living longer147 people · 2 studies · 1 found nothing
35 of the 36 indexed goals have no study of any kind behind Angiotensin II
No study in people, animals or cells on this page reports a result for these. That does not prove Angiotensin II does nothing for them. It does mean anything you have heard about Angiotensin II and one of these did not come from a study cited here.
Show full evidence
What is Angiotensin II?
Angiotensin II is the body's main hormone for raising blood pressure. It is approved as a drip for shock, when blood pressure will not hold even on standard drugs. In the main study of 344 people, it raised blood pressure. By day 28, 46 percent on the drug had died, against 54 percent on a dummy drip. That gap was too small to rule out chance.
Angiotensin II is a small hormone, 8 building blocks long. The body cuts it from a bigger protein in two steps, using renin and then ACE. It is the working end of the body's main blood pressure system. It squeezes blood vessels, releases a salt hormone called aldosterone and makes the body hold on to salt. Most people know it from the drugs that block it. ACE inhibitors and ARBs, two kinds of blood pressure pill, are among the most prescribed medicines in the world.
Since 2017 it has also been a drug of its own. The ATHOS-3 study took 344 adults in shock whose blood vessels had gone slack. They were already on high doses of norepinephrine or a similar drug. They got an angiotensin II drip or a dummy drip, and 321 were counted. The main goal was a rise in blood pressure by hour 3. That happened in 69.9 percent on angiotensin II and 23.4 percent on the dummy drip. By day 28, 46 percent had died on the drug against 54 percent on the dummy drip. That gap was too small to rule out chance. The company that sells the drug, La Jolla Pharmaceutical, paid for the study.
We checked the US drug records on 11 September 2026. GIAPREZA, application NDA 209360, from La Jolla Pharma, was first approved on 21 December 2017. Two forms are listed as prescription and one as discontinued. A generic angiotensin II acetate injection from Gland (ANDA 216966) was approved on 3 June 2025.
This is an intensive care drug. Half of it is gone from the blood in under a minute. It is given by drip through a large vein to people already on several blood pressure drugs. It has no wellness, performance or longer life use. There is no pill and no home shot.
How does Angiotensin II work?
In people, angiotensin II docks on the AT1 receptor on blood vessel muscle and squeezes the vessels. It also docks on the adrenal glands and releases aldosterone, which makes the body hold on to salt and water. A second receptor, AT2, mostly does the opposite. In this kind of shock, the body's usual blood pressure systems are maxed out or failing. The idea behind giving angiotensin II is that it raises blood pressure through a third, separate system. Its counterweight in the same family, angiotensin-(1-7), has its own page.
What have studies in people found about Angiotensin II?
One large study in 344 very sick adults, compared with a dummy drip. Several later looks back inside that same study. And small records from hospitals that started using the drug. Everything published is from intensive care.
- ATHOS-3 (2017): 344 people, 321 counted. Blood pressure rose by hour 3 in 69.9 percent on the drug against 23.4 percent on the dummy drip. An organ failure score for the heart and circulation improved more on angiotensin II (down 1.75 against 1.28 points). By day 28, 46 percent had died on the drug against 54 percent on the dummy drip, a gap too small to rule out chance. Serious problems were reported in 60.7 percent on the drug and 67.1 percent on the dummy drip. The maker paid.
- Hospital records (2022): 147 intensive care patients on 3 or more blood pressure drugs, 56 of them given angiotensin II. After adjusting, 86.0 percent died with angiotensin II and 71.0 percent without, a gap that could be chance. The drug went to the patients doing worst, so the groups were not a fair match.
- Renin look-back at ATHOS-3 (2020): tested whether a blood hormone called renin picks out the patients most likely to benefit.
- Early-start look-back at ATHOS-3 (2023): looked at starting the drip when patients were on lower doses of other blood pressure drugs.
What this does not tell you: The main study's goal was a blood pressure number at 3 hours, not survival. It was not big enough to settle whether the drug saves lives. Everyone studied was in intensive care on high doses of blood pressure drugs. So nothing here carries over to anyone else, any other dose or any other way of taking it. There is no long-term use, no take-home form, and no data at all on the uses that peptide marketing links to this hormone.
The state of the research
Angiotensin II is unusual among approved peptides because heart medicine spends most of its time blocking it. ACE inhibitors and ARBs exist to lower it. The evidence that doing so prevents heart attacks, strokes and kidney failure comes from studies of hundreds of thousands of people. The drug approval runs the other way. It is for a narrow rescue, when blood pressure will not hold.
The approval also shows what a stand-in measure buys you and what it does not. The FDA accepted a blood pressure rise at 3 hours, and the drug clearly did that. Whether it keeps people alive is still open. In ATHOS-3, the death numbers leaned in the drug's favour, but the gap could have been chance. The largest real-world hospital record so far leans the other way. It cannot separate the drug from how sick the people getting it were. Since June 2025 there has been a generic. That usually means no company has a money reason left to run a study big enough to settle survival.
The evidence, in charts
Fig. 1a · how many people
835people, across 3 studies in people cited here
| Study | People | Share |
|---|---|---|
| ATHOS-3, New England Journal of Medicine 2017 | 344 | 41% |
| Critical Care 2023 | 344 | 41% |
| Critical Care Explorations 2022 | 147 | 18% |
Counts are the number of people each study on this page says it signed up. That includes studies that only watched people and gave nobody the compound. 2 more studies in people give no headcount and are not counted here. Studies still signing people up are left out, and only studies cited on this page are counted.
Fig. 1b · evidence mix
5 of 6 sources here are studies in people. The rest is not.
- Study in people · done in people583%
- Review of studies · sums up other studies117%
Counted from the list of sources on this page. It counts only what we cite, so there may be more studies out there. A review counts once, however many studies it sums up.
Fig. 2 · evidence over time
The studies cover 5 different years, 2004 to 2023, counted from the list of sources on this page.
Fig. 3 · legal status at a glance
US
Approved
UK
Prescription
AU
Prescription
CA
Prescription
Approved in 1 of 4, by prescription in 3, not approved in 0. This is what the law says, not a verdict on the science. See Legal status below for the full text and any notes.
Fig. 5 · what the molecule is
- Kind of compound
- Peptide
- Molecule weight
- About 1,046 Da as the free base, per the GIAPREZA label
- Half-life
- Stated in words, not a numbersee the exact wording below
- Chain length
- 8 amino acidscounted from the chain below
DRVYIHPF
- Water-shy 4
- Water-loving 1
- Acidic 1
- Basic 2
One square per amino acid, left to right from the start of the chain, coloured by type. The type is a fact about the amino acid, not a finding about this compound.
The studies we cite
- Study in people2017Angiotensin II for the Treatment of Vasodilatory Shock
It lifted blood pressure, which is what it was approved for, and it did not clearly save lives. 344 adults whose blood pressure kept failing on standard drugs were put into two groups. One got angiotensin II by drip, the other a dummy drip. Blood pressure responded in about 70 percent on the drug and 23 percent on the dummy. By day 28, 46 percent on the drug had died against 54 percent on the dummy, a gap too small to call. The maker paid for the study.
ATHOS-3: 344 adults with catecholamine-resistant vasodilatory shock randomised, 321 analysed. A mean arterial pressure response at hour 3 occurred in 114 of 163 (69.9 percent) on angiotensin II and 37 of 158 (23.4 percent) on placebo, odds ratio 7.95, 95 percent confidence interval 4.76 to 13.3. Death by day 28 was 46 percent versus 54 percent, hazard ratio 0.78, 95 percent confidence interval 0.57 to 1.07. Funded by La Jolla Pharmaceutical Company.
- Study in people2020Renin and Survival in Patients Given Angiotensin II for Catecholamine-Resistant Vasodilatory Shock. A Clinical Trial
This looked for the patients the drug might actually help, and found a candidate. Blood samples from the shock trial were tested for renin, a hormone that runs high when this system fails. Three quarters of the patients had high levels. Among those with the highest renin, far fewer died by day 28 on the drug than on the dummy. This is a look back inside one trial at a group picked after the fact. It points to a study someone should run, not to an answer.
Analysis of the ATHOS-3 population examining baseline and follow-up renin concentrations against survival, testing whether renin identifies which patients respond.
- Study in people2023Initiating angiotensin II at lower vasopressor doses in vasodilatory shock: an exploratory post-hoc analysis of the ATHOS-3 clinical trial
Starting the drug earlier looked better than starting it late. The researchers went back through the same shock trial and sorted patients by how much other blood pressure medicine they were already on. Among those on lower amounts, about half as many died within 28 days on angiotensin II as on the dummy drip. Among those already on high amounts, there was no difference at all. This split was chosen after the results were known. It is a hint for the next trial, not a finding.
Exploratory post-hoc analysis of the same 344 patient trial asking whether starting angiotensin II at lower background vasopressor doses changes outcomes. Post-hoc and exploratory, so hypothesis generating only.
- Study in people2022Effectiveness of Angiotensin II for Catecholamine Refractory Septic or Distributive Shock on Mortality: A Propensity Score Weighted Analysis of Real-World Experience in the Medical ICU
In real hospital use the people given this drug did worse, and that is probably because they were sicker. Doctors looked back at records for 147 patients in one intensive care unit who needed three or more blood pressure drugs. 56 of them were given angiotensin II. 86 percent of those patients died, against 71 percent of the rest. Nobody was picked by chance here. The drug went to the patients in the most trouble, so the two groups were never comparable.
Retrospective single-centre cohort of 147 patients needing 3 or more vasopressors, 56 given angiotensin II. After propensity score weighting mortality was 86.0 percent with angiotensin II and 71.0 percent without, a difference that was not statistically significant (p = 0.16), and more angiotensin II patients still required 5 or more vasopressors (45.9 versus 12.5 percent, p < 0.01). Observational, and the sicker patients were the ones given the drug.
- Study in people2017ATHOS-3: A Phase 3 Study of LJPC-501 in Patients With Catecholamine-Resistant Hypotension
This is the registry entry for the main trial, and it holds no results. It records that the study ran, enrolled 344 people, finished, and was sponsored by the company that sells the drug. Nothing about what happened to those people is posted here. The results live in the published paper instead.
Registry record for the pivotal trial: phase 3, 344 participants enrolled, completed, lead sponsor La Jolla Pharmaceutical Company. No results are posted in the registry record itself.
- Review of studies2004Bradykinin receptor ligands: therapeutic perspectives
A review of the kinin system. It matters here because ACE both makes angiotensin II and breaks down bradykinin. So blocking ACE moves two hormones at once.
Review of the kinin system, which matters here because angiotensin-converting enzyme both makes angiotensin II and destroys bradykinin, so blocking it moves two peptides at once.
Where to buy Angiotensin II
Angiotensin II is an approved medicine. The approved product comes from a pharmacy, with a prescription. The vials below are sold “for research” and are not the approved drug.
1 seller lists Angiotensin II in our latest read. They are ranked by trust score, then by archive rating, then by certificate tier, then by the lowest price per milligram. Archive evidence is counted before source-backed. Each path is out of 4, and the two are not added. A higher price does not raise the score. The letter is the certificate chip. 0 of them have a published certificate that names Angiotensin II.
Some seller links may pay this site when you buy through them. A payment never changes a seller's tier or rank, and no seller has a say in any page.
| Seller | Trust score | Vial sizes | From, per mg | Certificate for Angiotensin II | Seller link |
|---|---|---|---|---|---|
| Boston Molecules | 28 InsufficientSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $33.7 | None found for Angiotensin II | View |
- LC Lab-confirmed: the issuing laboratory echoed this certificate back
- A Current certificate, independent laboratory named, laboratory not yet checked
- B Certificate published, but no laboratory link, older than a year, or the laboratory did not recognise the published lookup
- C No certificate could be read
Every listing and vial size for Angiotensin II · How the trust score is counted
Sellers named on the price pages are ranked by certificate tier, then price, and any affiliate income is disclosed there. Naming a seller is not a recommendation to buy or use anything.
Common questions
Has Angiotensin II been tested in people?
Yes. 344 people given it across 1 completed trial cited here, 0 of which found nothing. Angiotensin II is the body's main hormone for raising blood pressure.
What is the Angiotensin II dosage?
Approved medicine. No human dose established for unlabelled uses. Labeled amounts sit on the prescribing information. This page records what trials measured, not a personal dose. FDA approved 21 December 2017 (GIAPREZA, NDA 209360) to raise blood pressure in adults in shock from a severe infection (septic shock) or other shock where the blood vessels open too wide. Prescription only, given by drip into a vein. A generic angiotensin II acetate injection was approved 3 June 2025 (ANDA 216966).
Is Angiotensin II FDA-approved?
FDA approved 21 December 2017 (GIAPREZA, NDA 209360) to raise blood pressure in adults in shock from a severe infection (septic shock) or other shock where the blood vessels open too wide. Prescription only, given by drip into a vein. A generic angiotensin II acetate injection was approved 3 June 2025 (ANDA 216966).
Is angiotensin II a peptide drug you can buy?
No. It is a prescription drip used in intensive care for shock that no longer responds to standard blood pressure drugs. Half of it is gone from the blood in under a minute. So there is no pill, no shot and no take-home form.
Does it save lives in shock?
That has not been shown. In the main 344 person study, 46 percent on angiotensin II had died by day 28, against 54 percent on a dummy drip. That gap was small enough that it could be chance. What the study did show is that the drug raises blood pressure when other drugs have failed.
Why do most drugs block angiotensin II if it is also a medicine?
Because angiotensin II that stays high for years drives high blood pressure, heart damage and kidney damage. Lowering it with ACE inhibitors or ARBs prevents heart attacks and strokes. Giving it on purpose is a short rescue when blood pressure has collapsed. That is a totally different situation from long-term blood pressure control.
Is it still marketed?
Yes. On the 11 September 2026 FDA check, two GIAPREZA forms were listed as prescription and one as discontinued. A generic angiotensin II acetate injection approved in June 2025 is listed as prescription.