Desmopressin (patient information)
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alberto Plate [2]
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Overview
Desmopressin (patient information) is a hemostatic and endocrine-metabolic agent that is FDA approved for the treatment of central diabetes insipidus and primary nocturnal enuresis. Common adverse reactions include fatigue and rhinitis.
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
Central Cranial Diabetes Insipidus
- Dosage:
- Injection: 0.5mL - 1.0mL at 4 mcg/mL IV or SC, usually divided in two doses
- Tablets: 0.05 mcg PO q12h. Total daily dosage should be increased or decreased in the range of 0.1 mg to 1.2 mg divided into two or three daily doses as needed to obtain adequate antidiuresis.
- Rhinal Spray: 0.1 to 0.4 mL daily, either as a single dose or divided into two or three doses.
Hemophilia A with factor VIII Coagulant Activity > 5%
- Dosage
- Injection: 4 mcg/mL IV at 0.3 mcg/kg of body weight infused in 15-30 minutes. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended.
Von Willebrand's Disease
- Dosage:
- Injection: 4 mcg/mL IV at 0.3 mcg/kg of body weight infused in 15-30 minutes. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Desmopressin (patient information) in adult patients.
Non–Guideline-Supported Use
Diagnosis of Cushing's Syndrome
- Dosage: 5-10 mcg IV has proven ability to stimulate the pituitary-adrenal axis in a set of patients with Cushing's Syndrome, being useful in the differential diagnosis of the given pathology. [1]
Ehlers-Danlos Syndrome
Evidence: profilaxis during labour against bleeding. [2]
Hemorrhage-Uremia=
- Dosage: 0.4 microgram/kg IV infusion in patients with chronic renal failure, shortened bleeding time. [3]
Nocturia
- Dosage: 100 mcg (men) and 25 mcg (women) reduces nocturnal voids in 33%. [4]
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
Primary Nocturnal Enuresis
- Dosage:
- Tablets: (Patients >6 years): Initial dose of 0.2 mg at bedtime. The dose may be titrated up to 0.6 mg to achieve the desired response.
Central Cranial Diabetes Insipidus
- Dosage:
- Rhinal Spray: (Patients 3 months - 12 years old), 0.05 to 0.3 mL daily, either as a single dose or divided into two doses.
Hemophilia A with factor VIII Coagulant Activity > 5%
- Dosage:
- Injection: 4 mcg/mL IV at 0.3 mcg/kg of body weight infused in 15-30 minutes. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended.
Von Willebrand's Disease
- Dosage:
- Injection: 4 mcg/mL IV at 0.3 mcg/kg of body weight infused in 15-30 minutes. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Desmopressin (patient information) in pediatric patients.
Non–Guideline-Supported Use
Urinary Incontinence
- Dosage: Desmopressin administered at bedtime at increasing dosages from 10 to 30 mcg with intranasal spray until effective. [5]
Contraindications
Contraindicated in:
*Individuals with known hypersensitivity to desmopressin acetate or to any of the components of DDAVP tablets.
- Patients with moderate to severe renal impairment (defined as a creatinine clearance below 50ml/min).
- Patients with hyponatremia or a history of hyponatremia.
Warnings
There is limited information regarding Desmopressin (patient information) Warnings' in the drug label.
Adverse Reactions
Clinical Trials Experience
There is limited information regarding Desmopressin (patient information) Clinical Trials Experience in the drug label.
Postmarketing Experience
There is limited information regarding Desmopressin (patient information) Postmarketing Experience in the drug label.
Drug Interactions
There is limited information regarding Desmopressin (patient information) Drug Interactions in the drug label.
Use in Specific Populations
Pregnancy
Pregnancy Category (FDA):
There is no FDA guidance on usage of Desmopressin (patient information) in women who are pregnant.
Pregnancy Category (AUS):
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Desmopressin (patient information) in women who are pregnant.
Labor and Delivery
There is no FDA guidance on use of Desmopressin (patient information) during labor and delivery.
Nursing Mothers
There is no FDA guidance on the use of Desmopressin (patient information) in women who are nursing.
Pediatric Use
There is no FDA guidance on the use of Desmopressin (patient information) in pediatric settings.
Geriatic Use
There is no FDA guidance on the use of Desmopressin (patient information) in geriatric settings.
Gender
There is no FDA guidance on the use of Desmopressin (patient information) with respect to specific gender populations.
Race
There is no FDA guidance on the use of Desmopressin (patient information) with respect to specific racial populations.
Renal Impairment
There is no FDA guidance on the use of Desmopressin (patient information) in patients with renal impairment.
Hepatic Impairment
There is no FDA guidance on the use of Desmopressin (patient information) in patients with hepatic impairment.
Females of Reproductive Potential and Males
There is no FDA guidance on the use of Desmopressin (patient information) in women of reproductive potentials and males.
Immunocompromised Patients
There is no FDA guidance one the use of Desmopressin (patient information) in patients who are immunocompromised.
Administration and Monitoring
Administration
There is limited information regarding Desmopressin (patient information) Administration in the drug label.
Monitoring
There is limited information regarding Desmopressin (patient information) Monitoring in the drug label.
IV Compatibility
There is limited information regarding the compatibility of Desmopressin (patient information) and IV administrations.
Overdosage
There is limited information regarding Desmopressin (patient information) overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.
Pharmacology
There is limited information regarding Desmopressin (patient information) Pharmacology in the drug label.
Mechanism of Action
There is limited information regarding Desmopressin (patient information) Mechanism of Action in the drug label.
Structure
There is limited information regarding Desmopressin (patient information) Structure in the drug label.
Pharmacodynamics
There is limited information regarding Desmopressin (patient information) Pharmacodynamics in the drug label.
Pharmacokinetics
There is limited information regarding Desmopressin (patient information) Pharmacokinetics in the drug label.
Nonclinical Toxicology
There is limited information regarding Desmopressin (patient information) Nonclinical Toxicology in the drug label.
Clinical Studies
There is limited information regarding Desmopressin (patient information) Clinical Studies in the drug label.
How Supplied
There is limited information regarding Desmopressin (patient information) How Supplied in the drug label.
Storage
There is limited information regarding Desmopressin (patient information) Storage in the drug label.
Images
Drug Images
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Package and Label Display Panel
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Patient Counseling Information
There is limited information regarding Desmopressin (patient information) Patient Counseling Information in the drug label.
Precautions with Alcohol
Alcohol-Desmopressin (patient information) interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Brand Names
There is limited information regarding Desmopressin (patient information) Brand Names in the drug label.
Look-Alike Drug Names
There is limited information regarding Desmopressin (patient information) Look-Alike Drug Names in the drug label.
Drug Shortage Status
Price
References
The contents of this FDA label are provided by the National Library of Medicine.
- ↑ Malerbi DA, Mendonça BB, Liberman B, Toledo SP, Corradini MC, Cunha-Neto MB; et al. (1993). "The desmopressin stimulation test in the differential diagnosis of Cushing's syndrome". Clin Endocrinol (Oxf). 38 (5): 463–72. PMID 8330442.
- ↑ Rochelson B, Caruso R, Davenport D, Kaelber A (1991). "The use of prophylactic desmopressin (DDAVP) in labor to prevent hemorrhage in a patient with Ehlers-Danlos syndrome". N Y State J Med. 91 (6): 268–9. PMID 1861812.
- ↑ Watson AJ, Keogh JA (1984). "1-Deamino-8-d-arginine vasopressin (DDAVP): a potential new treatment for the bleeding diathesis of acute renal failure". Pharmatherapeutica. 3 (9): 618–22. PMID 6728864.
- ↑ Weiss JP, Zinner NR, Klein BM, Nørgaard JP (2012). "Desmopressin orally disintegrating tablet effectively reduces nocturia: results of a randomized, double-blind, placebo-controlled trial". Neurourol Urodyn. 31 (4): 441–7. doi:10.1002/nau.22243. PMID 22447415.
- ↑ Caione P, Nappo S, De Castro R, Prestipino M, Capozza N (1999). "Low-dose desmopressin in the treatment of nocturnal urinary incontinence in the exstrophy-epispadias complex". BJU Int. 84 (3): 329–34. PMID 10468731.
Why this medication is prescribed
Desmopressin is a chemical that is similar to a hormone found naturally in your body. It increases urine concentration and decreases urine production. Desmopressin is used to prevent and control excessive thirst, urination, and dehydration caused by injury, surgery, and certain medical conditions, allowing you to sleep through the night without awakening to urinate. It is also used to treat specific types of diabetes insipidus and conditions after head injury or pituitary surgery.
How this medication should be used
Desmopressin comes in a liquid that is administered into the nose and as a nasal spray. It usually is used twice a day (every morning and evening). For bed wetting, it is used every evening at bedtime. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use desmopressin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Do not take the liquid by mouth. With the nasal liquid, you will receive a soft, flexible plastic tube with special markings for measuring the dose and instructions on how to measure and administer it. After drawing the dose into the tube, insert one end of the tube into your nose and the other end into your mouth. Blow on the tube to force the liquid high into your nose. Do not allow the liquid to run into your mouth. Follow the directions carefully; if you have difficulty using the drug or giving it to a child, ask your doctor or pharmacist for advice.
To use the nasal spray, first clear your nasal passages by gently blowing your nose. Insert the sprayer into a nostril. Sniff as you squeeze the sprayer once. To prevent mucus from entering the sprayer, release your grip after you remove the sprayer from your nose. Gently sniff two or three more times.
Other uses for this medicine
Desmopressin nasal spray may be used to treat a condition called chronic autonomic failure (when the body is not able to control urine production).
Talk to your doctor about the possible risks of using this drug for your condition.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Special precautions
Before using desmopressin:
- tell your doctor and pharmacist if you are allergic to desmopressin or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially carbamazepine (Tegretol), chlorpropamide (Diabinese), clofibrate (Atromid-S), demeclocycline (Declomycin), epinephrine, lithium, and vitamins.
- tell your doctor if you have or have ever had heart disease, high blood pressure, coronary artery disease, nose or sinus problems or surgery, or cystic fibrosis.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using desmopressin, call your doctor.
- you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
- remember that alcohol can add to the drowsiness caused by this drug.
Special dietary instructions
Your doctor may tell you to limit your intake of fluids. Follow your doctor's directions. Drinking too much causes water retention (bloating and swelling of the feet, ankles, and lower legs).
What to do if you forget a dose
Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.
Side effects
Desmopressin may cause side effects. If you experience any of the following symptoms, call your doctor immediately:
- upset stomach
- headache
- stuffy or runny nose
- reddening of the skin
- stomach cramps
- pain in the external genital area (in women)
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].
Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it in the refrigerator; do not freeze. The nasal bottle contains 25 or 50 doses. Throw away any medication after that. Do not put any leftover medication into another bottle. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Other information
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to desmopressin.
If desmopressin loses its effectiveness (if urination increases or you wake up earlier than usual to urinate), call your doctor. Your dose may need to be changed.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
Brand names
- DDAVP®
- DDAVP® Nasal Spray
- DDAVP® Rhinal Tube
- DDVP®
- Stimate® Nasal Spray