Desmopressin

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Generic Name: Desmopressin Brand Name(s): Generics only. No brands available.

Uses

What is Desmopressin used for?

Desmopressin is commonly used to control the amount of urine your kidneys make. Normally, the amount of urine you make is controlled by a certain substance in the body called vasopressin. In people who have “water diabetes” (diabetes insipidus) or certain kinds of head injury or brain surgery, the body does not make enough vasopressin. Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. This medication helps to control increased thirst and too much urination due to these conditions, and helps prevent dehydration.

Desmopressin is also used to control nighttime bedwetting in children. It reduces how often your child urinates and decreases the number of bedwetting episodes.

How should I take Desmopressin?

For the treatment of diabetes insipidus, take this medication by mouth, usually 2 to 3 times a day or as directed by your doctor.

For the treatment of bedwetting, take this medication by mouth, usually once a day at bedtime. Children should limit the fluids they drink after dinner, especially 1 hour before the desmopressin dose until the next morning, or at least 8 hours after the dose. If your child wakes up during the night, limit the amount that he or she drinks.

All patients taking desmopressin, especially children and older adults, must limit drinking of water and other fluids. Consult your doctor for details. If you find that you are drinking more fluids than directed, tell your doctor right away. Your treatment will need to be adjusted.

Dosage is based on your medical condition and response to treatment. Do not take more desmopressin or take it more often than prescribed.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Tell your doctor if your condition does not improve or if this medication stops working well.

How do I store Desmopressin?

Desmopressin is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Desmopressin in the bathroom or the freezer. There may be different brands of Desmopressin that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Desmopressin down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Desmopressin?

Before taking desmopressin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: kidney disease, a low level of sodium in the blood (current or past hyponatremia).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood pressure, heart disease (such as blocked blood vessels in the heart), conditions that may increase your risk of fluid/mineral imbalance (such as cystic fibrosis, heart failure), the urge to drink too much water without being thirsty, bleeding/clotting problems.

If you have lost too much body water (become dehydrated), your doctor will correct that condition first before starting treatment with desmopressin.

Limit alcohol because it can interfere with how well desmopressin works.

Tell the doctor right away if you develop any illness that can cause water/mineral imbalance (including fever, diarrhea, vomiting, infections such as the flu) or if you experience conditions that require drinking more fluids (for example, exposure to very hot weather, strenuous exercise, persistent sweating). The doctor may need to stop or adjust desmopressin treatment, especially in children and older adults.

Children may be more sensitive to the side effects of this drug, especially water/mineral imbalance and a low level of sodium in the blood.

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, older adults may be at greater risk for water/mineral imbalance and a low level of sodium in the blood while using this drug.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Desmopressin during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Desmopressin. This Desmopressin is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Desmopressin?

Headache, nausea, upset stomach, or flushing of the face may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Desmopressin can rarely cause a low level of sodium in the blood, which can be serious and possibly life-threatening. Drinking too much water or other fluids increases the risk of having a low level of sodium in the blood. Therefore, follow your doctor’s directions for limiting fluids. Seek immediate medical attention if you have any of these unlikely but serious symptoms of a low level of sodium in the blood: loss of appetite, severe nausea, vomiting, severe headache, muscle weakness/spasms/cramps, sudden weight gain, unusual tiredness, unusual severe drowsiness, mental/mood changes (such as confusion, hallucinations, irritability), loss of consciousness, seizures, slow/shallow breathing.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Desmopressin?

Other medications besides desmopressin may also affect the balance of water and sodium in your body. Therefore, tell your doctor or pharmacist about all the products you take, including: nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen), psychiatric medicines (such as chlorpromazine), SSRI antidepressants (such as sertraline), tolvaptan, tricyclic antidepressants (such as amitriptyline), “water pills” (diuretics such as furosemide).

Desmopressin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Desmopressin?

Desmopressin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Desmopressin?

Desmopressin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Desmopressin.

What is the dose of Desmopressin for an adult?

Usual Adult Dose for Diabetes Insipidus

Initial dose: 0.05 mg orally twice a day or

1 to 2 mcg IV twice a day or

1 to 2 mcg subcutaneously twice a day or

5 to 40 mcg spray intranasally twice a day or

0.1 to 0.4 mL via rhinal tube intranasally twice a day.

The optimal dosage depends on the patient’s response (duration of sleep and adequate, not excessive water turnover). The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover.

Usual Adult Dose for Hemophilia A

IV: 0.3 mcg/kg once slowly over 15-30 minutes. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. Blood pressure and heart rate monitoring during infusion is recommended. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient.

Intranasal: 1 spray (1.5 mg/mL) in each nostril one time.

Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient.

Usual Adult Dose for von Willebrand’s Disease

IV: 0.3 mcg/kg once slowly over 15-30 minutes. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. Blood pressure and heart rate monitoring during infusion is recommended. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient.

Intranasal: 1 spray (1.5 mg/mL) in each nostril one time.

Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient. The nasal spray should not be used to treat patients with type IIB von Willebrand’s disease since platelet aggregation may be induced.

Usual Adult Dose for Primary Nocturnal Enuresis

Oral: 0.2 to 0.6 mg once before bedtime.

Renal Dose Adjustments

Desmopressin is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min).

Precautions

When desmopressin is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular pediatric and geriatric patients, fluid intake should be adjusted downward to decrease to potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain). Desmopressin intranasal formulations are no longer indicated for the treatment of primary nocturnal enuresis due to the risk for developing severe hyponatremia that can result in seizures and death.

Other Comments

The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose.

What is the dose of Desmopressin for a child?

Usual Pediatric Dose for Diabetes Insipidus

Infants 3 months of age to children 12 years of age:

Intranasal: 5 mcg/day as a single dose or in 2 divided doses. Dose range is 5 to 30 mcg/day. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover.

Oral: 0.05 mg twice a day. Dose range is 0.1 to 0.8 mg daily.

IV and subcutaneously: No definitive dosing available. Adult dosing should not be used in this age group; adverse events such as hyponatremia-induced seizures may occur. Dose should be reduced. Some have suggested an initial dosage range of 0.1 to 1 mcg in 1 or 2 divided doses. Initiate at low dose and increase as necessary. Closely monitor serum sodium levels and urine output; fluid restriction is recommended.

Children more than 12 years of age:

Intranasal: 5 to 40 mcg/day divided into 1 to 3 doses. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover.

Oral: 0.05 mg twice daily. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses.

IV: 1 to 2 mcg twice a day

Subcutaneously: 1 to 2 mcg twice a day

Use in children requires careful fluid intake restrictions to prevent possible hyponatremia and water intoxication. The optimal dosage depends on the patient’s response (duration of sleep and adequate, not excessive water turnover).

Usual Pediatric Dose for Hemophilia A

Infants 3 months of age and children:

IV: 0.3 mcg/kg by slow infusion over 15-30 minutes beginning 30 minutes before procedure. May repeat dose if needed.

Children more than 12 years of age:

IV: 0.3 mcg/kg once slowly over 15-30 minutes.

Intranasal:

50 kg or less: 150 mcg

more than 50 kg: 150 mcg in each nostril.

Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient.

Usual Pediatric Dose for von Willebrand’s Disease

Infants 3 months of age and children:

IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. May repeat dose if needed.

Children more than 12 years of age:

IV: 0.3 mcg/kg once slowly over 15 to 30 minutes.

Intranasal:

50 kg or less: 150 mcg

More than 50 kg: 150 mcg in each nostril.

Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient. The nasal spray should not be used to treat patients with type IIB von Willebrand’s disease since platelet aggregation may be induced.

Usual Pediatric Dose for Primary Nocturnal Enuresis

6 years or older:

0.2 to 0.6 mg orally once daily before bedtime.

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Desmopressin available?

Desmopressin is available in the following dosage forms and strengths:

  • Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Desmopressin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: January 19, 2018 | Last Modified: January 19, 2018

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