If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. Medically reviewed by Drugs.com. The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Pharmacokinetics and pharmacodynamics in clinical use of scopolamine. Baseline renal function should be assessed. After a 300 mcg intranasal dose of desmopressin levels of Factor VIII and vWF remain greater than 30 units/dL for 8 hours. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Longer DOA. Persons with renal disease may be at increased risk for low sodium concentrations, fluid overload, and electrolyte abnormalities. Desmopressin acetate should not be used to treat patients with Type IIB von Willebrands disease since platelet aggregation may be induced. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. What is the difference in Nocdurna dosage between men and women. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. eCollection 2023. Maximal dose-response increase in Factor VIII activity occurs at 0.3 to 0.4 mcg/kg desmopressin. 2022 Mar 8;7(1):e000852. Chlorpheniramine; Dihydrocodeine; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Children younger than 12 years of ageUse and dose must be determined by your doctor. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. Serum concentrations of potassium, sodium, and creatinine do not change following the administration of desmopressin, and urinary excretion of potassium and sodium also remains the same. Flurbiprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 1.5-2 mg IM/SC = 6-7 mg PO. Caution should be used when coadministering these agents. In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. When switching from DDAVP Nasal Spray to DDAVP Injection, the starting dose is one-tenth times the DDAVP Nasal Spray dose. Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. Azilsartan; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. If used to reduce spontaneous or traumatic bleeding, doses may be repeated after 8 hours to 12 hours and once daily thereafter, if needed, based upon clinical condition and von Willebrand factor and factor VIII levels. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Piroxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Cisplatin: (Moderate) Frequently monitor serum sodium levels if concurrent use of desmopressin and cisplatin is necessary. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. > = 12 years and adult: 2-4 mcg/day IV/SC divided BID or 1/10 of the . Dependent on route of administration and indication for therapy. Commonly central DI is treated with desmopressin. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Dose range is 5 to 30 mcg/day. Caution should be used when coadministering these agents. A woman who took both desmopressin and ibuprofen was found in a comatose state. Benazepril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Caution should be used when coadministering these agents. {+/7VPerb}6Wz+>8. Consider other treatment options for this condition. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Oxycodone: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Dose should be reduced. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Lamotrigine: (Major) Caution is recommended if a drug that may increase the risk of water intoxication with hyponatremia, such as lamotrigine, is administered with desmopressin acetate. Avoid spraying in the eyes. Atenolol; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. DDAVP Rhinal TubeDDAVP Rhinal tube is used to administer desmopressin doses less than 10 mcg (less than 0.1 mL).Break the seal on the bottle and remove cap. The administration of carbamazepine prior to administration of desmopressin may act to reduce the duration of action of desmopressin. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ketorolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Available for Android and iOS devices. Desmopressin in nocturnal enuresis 677,ug given intranasally wasequivalent to 400[ig given orally.8 Wedecidedto comparethe 20 igintranasal dose with the 200 tg oral dose, whichwefoundin a pilot study to be as effective as a 400 ptg dose, but with less effect on serum electrolytes and body weight. Do not dilute DDAVP Injection for the Diabetes Insipidus population. Following oral administration, the half-life of desmopressin is about 1.5 to 2.5 hours and is independent of dosage. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Individualize dosing to prevent an excessive decrease in plasma osmolality, which can lead to hyponatremia and possible seizures. Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. % Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. In certain clinical situations, it may be justified to try desmopressin in persons with factor VIII concentrations of 2% to 5%; however, carefully monitor these patients. DDAVP ( desmopressin) is a synthetic analog of vasopressin (antidiuretic hormone) that promotes release of factor VIII Reversing anticoagulation and achieving hemostasis after cardiopulmonary bypass Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. eCollection 2022. (Synthetic analog of vasopressin-posterior pituitary hormone). It is not known whether antibodies to desmopressin injection are produced after repeated injections. Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Idiopathic partial central diabetes insipidus. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Hemophilia A and von Willebrand's Disease (Type I): The recommended dosage is 0.3 mcg/kg actual body weight (to a maximum of 20 mcg) administered by intravenous infusion over 15 minutes to 30 minutes. Further hospitalization cost saving may be achieved through reduced Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Consider risk vs. benefit as pregnant women with Hemophilia A or von Willebrand's disease as these patients may be at an increased risk for bleeding diatheses and hemorrhagic events at delivery; affected neonates may also be at risk of bleeding diatheses. endobj Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Monitor serum sodium concentrations within 1 week and then approximately 1 month after treatment initiation and periodically thereafter. Provide short term protection for uremic hemorrhagic tendency: 0.3 mcg/kg ivpb q8h x 2 doses (diminishing response). Caution should be used when coadministering these agents. Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. endobj *L#n~i V3{kf_t.wjO_KgImL%4+GJ+Pp QsWAd._e7p!90&z {c`Kk;swZ/Nf{s~d? For a patient requiring volume resuscitation, a large volume of normal saline could be . Bookshelf Interrupt therapy for acute illness (e.g., systemic infection, fever, recurrent vomiting or diarrhea), extremely hot weather, vigorous exercise, or other conditions associated with increased water intake. Fluid restrictions should be observed. 1 to 2 mcg IV every 6 to 8 hours in combination with hypertonic saline. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Methods: Desmopressin is contraindicated in persons with hyponatremia or a history of hyponatremia, polydipsia, concomitant loop diuretic or systemic or inhaled corticosteroid therapy, known or suspected syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and other illnesses that can cause fluid and electrolyte imbalance, such as gastroenteritis, salt-wasting nephropathies, or systemic infection. When switching from DDAVP Tablets to DDAVP Injection, titrate dose individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) due to the large variability in both PK and PD. Ensure the patient is compliant with fluid restrictions and intake. Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Decrease bleeding following cardiac bypass: 0.3 mcg/kg ivpb. If there are dry nights after Desmopressin is used, continue using it for 3 months and then review your child's progress. Heparin: (Minor) Desmopressin has been shown to have an additive effect on the anticoagulant activity of heparin. Twist off the seal from the dropper. In a single study of postpartum women receiving a single dose of intranasal desmopressin, a marked change in plasma concentration of desmopressin was seen; however, little, if any, change in assayable desmopressin was found in breast milk. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Ketorolac (Toradol) The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. To investigate (1) the pharmacokinetic and pharmacodynamic profiles of desmopressin in men from an age group with a high incidence of nocturia; and (2) circadian variation in the pharmacokinetic parameters. In the elderly, careful dosage selection and monitoring of renal function are recommended. Renal concentration capacity testing in children below the age of 1 year should only be performed under carefully supervised conditions in hospital. Proposed sites of these receptors include endothelial cells, megakaryocytes, blood monocytes, and mast cells. DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. Adjust dose based upon response to treatment estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. DDAVP will also stop bleeding in hemophilia A patients with episodes of spontaneous or trauma-induced injuries such as hemarthroses, intramuscular hematomas or mucosal bleeding. SEQUENTIAL THERAPY : Refers to the act of replacing a parenteral version of a medication with its oral counterpart. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Monitor renal function and clinical status closely during use. Generic:- Closed containers will maintain stability for 3 weeks at controlled room temperature (68 to 77 degrees F)- Refrigerate (between 36 and 46 degrees F)DDAVP:- Discard product if it contains particulate matter, is cloudy, or discolored- Store in refrigerator at 2 to 8 degrees C (36 to 46 degrees F)Minirin:- Store at 77 degrees F; excursions permitted to 59-86 degrees F- Store uprightNocdurna:- Product should always be stored in the blister and only removed immediately before use- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in the original carton to protect from lightNoctiva:- Product must be used within 60 days after removal from refrigeration to room temperature (77 degrees F)- Store in refrigerator (36 to 46 degrees F), excursions permitted between 32 to 59 degrees F- Store uprightStimate:- Store at room temperature (up to 77 degrees F)- Store upright. Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Two children with diabetes insipidus had decreasing desmopressin requirements with lamotrigine initiation. 1990 Aug;66(2):175-6 Carbetapentane; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. documenting the conversion using the "IV to PO conversion" category. Wash the rhinal tube in water and shake well, until no water is left in the tube.To avoid the spread of infection, do not use the container for more than 1 person.For 2.5 mL bottles, discard after 25 sprays (doses) because the amount delivered thereafter per spray may be substantially less than the recommended dose. 2 mg PO - 15 mg IV. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Objective: To investigate (1) the pharmacokinetic and pharmacodynamic profiles of desmopressin in men from an age group with a high incidence of nocturia; and (2) circadian variation in the pharmacokinetic parameters. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. IV: 0.3 mcg/kg once slowly over 15-30 minutes. A woman who took both desmopressin and ibuprofen was found in a comatose state. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. doi: 10.1136/tsaco-2021-000852. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. After at least 7 days of treatment, the dose may be increased to 1.66 mcg, if needed, provided the serum sodium is within the normal range during treatment with the 0.83 mcg dose. When switching between formulations, the below text is meant as guidance for starting dose. Oral doses of 0.2 and 0.4 mg produce similar responses on urine volume and urine osmolality as 0.01 mg and 0.02 mg intranasal doses. WARNINGS When Desmopressin Acetate Injection is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular in pediatric and geriatric patients, fluid intake should be adjusted downward to decrease the potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain). Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Vasopressin (ADH) and AnalogsVasopressin analogs, Synthetic structural analog of vasopressin (antidiuretic hormone or ADH); more potent and much longer acting than vasopressin; many dosage forms including oral, injectable, sublingual, and intranasal formsUsed for the treatment of central diabetes insipidus, primary nocturnal enuresis (PNE), spontaneous bleeding or trauma-induced hemorrhage, bleeding prophylaxis (e.g., surgical bleeding), hemophilia A or mild to moderate von Willebrand's disease, and nocturia due to nocturnal polyuria in adultsThe intranasal formulation is no longer indicated to treat PNE secondary to reports of hyponatremic-related seizures sometimes resulting in death, DDAVP, Minirin, Nocdurna, Noctiva, Stimate, DDAVP Nasal Sol: 0.1mg, 1mLDDAVP/Desmopressin/Desmopressin Acetate Intravenous Inj Sol: 1ml, 4mcgDDAVP/Desmopressin/Desmopressin Acetate Oral Tab: 0.1mg, 0.2mgDDAVP/Desmopressin/Desmopressin Acetate Subcutaneous Inj Sol: 1ml, 4mcgDDAVP/Desmopressin/Desmopressin Acetate/Minirin/Noctiva/Stimate Nasal Spray Met: 0.1mg, 0.1mL, 0.75mcg, 1mL, 1.5mg, 1.5mcgNocdurna Sublingual Tablet, SL: 27.7mcg, 55.3mcg. Desmopressin is also used to control excessive thirst and the passage of an abnormally large amount of urine that may occur after a head injury or after certain types of surgery. Disclaimer. Cisplatin can cause hyponatremia, which may increase the risk of water intoxication in patients receiving treatment with desmopressin. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Dextromethorphan; Diphenhydramine; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Careful fluid intake restrictions are required in pediatric patients to prevent hyponatremia and water intoxication. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Immune Checkpoint Inhibitors as a Threat to the Hypothalamus-Pituitary Axis: A Completed Puzzle. and transmitted securely. Desmopressin is in a class of medications called hormones. Desmopressin nasal spray can be resumed when these conditions resolve. stream Guidelines recommend administering no more than once every 24 hours or for more than 3 consecutive days to minimize risk of hyponatremia and seizures. Last updated on Sep 28, 2022. government site. Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The volume of diluent is weight-based. Increased FVIII and vWF levels are thought to be due to their release from endogenous reservoirs and not increased synthesis since the response is so rapid. Selective serotonin reuptake inhibitors: (Minor) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including SSRIs. Q@xtt/ No adverse developmental outcomes were observed in animal reproduction studies with administration of desmopressin during organogenesis to pregnant rats and rabbits at doses approximately less than 1 and 38 times, respectively, the maximum recommended human dose based on body surface area (mg/m2). <> Single-dose administration has been used for uremic bleeding in patients with renal failure; however, repeat doses are not recommended. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. 1. Drugs; . Hvistendahl GM, Riis A, Nrgaard JP, Djurhuus JC. There are several recommended conversions ranging from 50 to 80% of the oral dose but the American Association of Clinical Endocrinologists/American Thyroid Association guidelines recommend an intravenous dose 50-70% of the patient's oral dose. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Brand Names. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Brompheniramine; Dextromethorphan; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Use desmopressin nasal spray for nocturia with caution and monitoring of blood volume status in persons with New York Heart Association Class I congestive heart failure. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Telmisartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. . Increased Factor VIII activity is noted 30 minutes after IV administration, with peak activity occurring in 90 minutes to 2 hours. Federal government websites often end in .gov or .mil. News Article Holder This page will generate the the news article from the ID supplied in the URL. Pharmacologic: antidiuretic hormones + + + Indications + + PO, SC, IV, Intranasal: Treatment of diabetes insipidus caused by a deficiency of vasopressin. anaphylactoid reactions / Rapid / 0-1.0anaphylactic shock / Rapid / 0-1.0seizures / Delayed / Incidence not knownwater intoxication / Delayed / Incidence not knowncoma / Early / Incidence not knownthrombosis / Delayed / Incidence not knownthromboembolism / Delayed / Incidence not knownstroke / Early / Incidence not knownmyocardial infarction / Delayed / Incidence not known, hyponatremia / Delayed / 0.9-12.0hypertension / Early / 1.7-2.6photophobia / Early / 0-2.0conjunctivitis / Delayed / 0-2.0confusion / Early / Incidence not knownelevated hepatic enzymes / Delayed / Incidence not knownhypotension / Rapid / Incidence not knownsinus tachycardia / Rapid / Incidence not knownpalpitations / Early / Incidence not knowninfertility / Delayed / Incidence not knownbalanitis / Delayed / Incidence not knowntolerance / Delayed / Incidence not known, xerostomia / Early / 0-14.0rhinitis / Early / 3.0-8.0headache / Early / 2.0-5.0pharyngitis / Delayed / 2.3-3.8dizziness / Early / 0-3.0epistaxis / Delayed / 2.0-3.0nasal congestion / Early / 1.4-2.9sneezing / Early / 2.3-2.6back pain / Delayed / 1.1-2.3chills / Rapid / 0-2.0asthenia / Delayed / 0-2.0rhinalgia / Early / 2.0-2.0ocular pruritus / Rapid / 0-2.0lacrimation / Early / 0-2.0diarrhea / Early / Incidence not knownabdominal pain / Early / Incidence not knowndyspepsia / Early / Incidence not knownnausea / Early / Incidence not knownlethargy / Early / Incidence not knownflushing / Rapid / Incidence not knowncough / Delayed / Incidence not knowninjection site reaction / Rapid / Incidence not knownoligospermia / Delayed / Incidence not known.
