Desmopressin
Other Hormones including Other Endocrine Drugs · Vasopressin analogue
Indications
Nocturnal enuresis. Diabetes insipidus; renal concentrating capacity diagnosis.
Dosage
Adults: TAB/SPRAY: Diabetes insipidus, treatment: TAB: Initially 300 mcg/day as t.i.d; maintenance, 300-600 mcg/day as t.i.d; range 0.2-1.2 mg/day. SPRAY: 10-40 mcg/day as od/bid doses. Diabetes insipidus, diagnosis: SPRAY: 20 mcg (limit fluid intake to 500 mL from 1 hr before to 8 hrs after administration); Adults above 65 yrs, 10-20 mcg at bed time, do not repeat dose within 24 hrs. Primary nocturnal enuresis (if urine concentrating ability normal). Nocturia associated with multiple sclerosis (when other treatments have failed): TAB: 200 mcg at bed time, only increased to 400 mcg if lower dose not effective; withdraw for at least 1 wk for reassessment after 3 mth. SPRAY: Adults above 65 yrs, 10-20 mcg at bed time, do not repeat dose within 24 hrs. Postoperative polyuria or polydipsia: Adjust dose according to urine osmolarity. Renal function testing: (Empty bladder at time of dose and…
Administration
IV: Dilute in 0.9% NaCl and infuse over 15-30 min; dose should be diluted in 10 mL NS for children < 10 kg; 50 mL NS for adults and children > 10 kg. Stability: Store under refrigeration at 2°C-8°C (36°F-46°F).
Adverse Effects
Overhydration, hyponatraemia, headache, nausea, stomach pain, nasal congestion, epistaxis, convulsions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Habitual, psychogenic polydipsia, cardiac insufficiency, unstable angina, Von Willebrand's disease Type IIB where risk of pseudothrombocytopenia. Do not perform fibrinolytic test in patients with hypertension, heart disease, cardiac insufficiency or other conditions requiring diuretic treatment. Precautions: Cardiovascular disease, cystic fibrosis, electrolyte imbalance, raised intracranial pressure, renal impairment. Avoid fluid overload; restrict fluid intake and check body wt and plasma osmolality regularly.
Interactions
Indomethacin, chlorpromazine, carbamazepine, other pressor agents, NSAIDs, TCADS, SSRIs.
Advice to Patient
Take with or without meals. Before use, refrigerate nasal solution. Prime nasal spray pump (only once) and spray dose into one or both nostrils, as prescribed, while inhaling briskly. Clean tip of sprayer with hot water and dry it with clean tissue. Keep track of doses given and discard bottle after 50 doses. Discard pump after 25 or 50 doses, depending on bottle, because delivery of an accurate dose cannot be assured. For nasal tube, draw prescribed amount of solution into calibrated plastic tube, insert one end of tube into a nostril and the other end into your mouth, and gently blow into tube to deposit solution deep into nasal cavity. Do not let drug drain into your mouth. Inform prescriber if there is increased weight, swelling of extremities. If you have diabetes insipidus and you are using intranasal product, check nasal membranes regularly and inform prescriber if there is…
Pharmacokinetics
Onset of action: Intranasal: Antidiuretic: 15-30 mins. Increased factor VIII and von Willebrand factor (VWF) activity (dose related): 30 mins. Peak effect: Antidiuretic: 1 hr. Increased factor VIII and VWF activity: 1.5 hrs. IV inf: Increased factor VIII and VWF activity: 30 mins (dose related). Peak effect: 1.5-2 hrs. Oral tab: Antidiuretic: Approx. 1 hr. Peak effect: 4-7 hrs. Duration: Intranasal, inj, oral tab: Approx. 6-14 hrs. Absorption: Sublingual: Rapid. Bioavailability: Intranasal: Approx. 3.5%. Oral tab: 5% compared to intranasal, 0.16% compared to IV. Half-life elimination: 2-4 hrs. Renal impairment: 9 hrs. Excretion: Urine (primarily).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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