ADH activity : Pressor activity [DDAVP: 2000-4000: 1 Vasopressin: 1:1]. May repeat dose after 8 to 12 hours and once daily thereafter as needed to reduce spontaneous or traumatic bleeding. Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or enteral nutrition and/or receiving oral medications Infection does not require IV antibiotics Afebrile (< 100.4F in the last 24 hours) Received 24 hours of IV antibiotics The antidiuretic effects of the drug last for about 5 to 21 hours, followed by an abrupt cessation of activity that occurs over a 60- to 90-minute period. Betamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Persons with renal disease may be at increased risk for low sodium concentrations, fluid overload, and electrolyte abnormalities. 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. once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. Single-dose administration has been used for uremic bleeding in patients with renal failure; however, repeat doses are not recommended. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. I would recommend making an appointment with your regular doctor to see what might be causing this. 2002 Jun;89(9):855-62 Preoperative doses may be given 2 hours prior to the scheduled procedure. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. So, if a patient is on a nasal (spray or intranasal) dose of 10mcg (0.1 ml) twice a day, then a suitable tablet oral dose may be 100mcg or 200mcg twice a day. Aminophylline IV Push IV Push IV Push IV Push IV bolus infuse over 20 -30 minutes not to exceed 25 mg/min; max concentration 25 mg/ml. The study had an open, randomised, four-way cross-over design. This places the solution in the nasal cavity and not down your throat.After use, reseal the dropper tip and close the bottle. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Fluticasone; Salmeterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Bupivacaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Monitor patients closely during the initial dose titration period. Desmopressin is contraindicated in patients with moderate to severe renal impairment (e.g., CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2). -, Br J Urol. IV: 100 mg IV bolus given immediately, followed by 25 to 75 mg IV every 6 hours or 200 mg/24 hours as a continuous IV infusion for the first 24 hours. There is no information on the effects of desmopressin on the breast-fed infant or on milk production. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. Sublingual TabletsThe patient should place the tablet under their tongue 1 hour before bedtime until it dissolves.Have the patient empty their bladder just before bedtime.Advise patients to limit the amount of water or liquids they drink from 1 hour before taking desmopressin sublingual tablet and until 8 hours after. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Ethacrynic Acid: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. %PDF-1.7 Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. MeSH A woman who took both desmopressin and ibuprofen was found in a comatose state. Infants 3 months of age and children: FOIA Bendroflumethiazide; Nadolol: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Oral to IV Conversion: The intravenous dose of levothyroxine is not the same as the oral dose. 2 0 obj Prolonged experience with desmopressin in pregnant women over several decades, based on the available published literature and case reports, have not identified a drug associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. eCollection 2022. R8cxz. Trauma Surg Acute Care Open. Caution should be used when coadministering these agents. Maintenance dose range: 10 mcg/day to 30 mcg/day intranasally (0.1 mL/day to 0.3 mL/day) in 1 to 2 divided doses. 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). 1 After the original clinical study performed in Italy, desmopressin was used in Following oral administration, the bioavailability of desmopressin is about 5% and 0.16% compared to intranasal and intravenous administration, respectively. Barnabei A, Corsello A, Paragliola RM, Iannantuono GM, Falzone L, Corsello SM, Torino F. Cancers (Basel). Desmopressin (dDAVP), a synthetic analogue of 8-arginine vasopressin (ADH), is an antidiuretic . Adjust treatment according to the diurnal pattern of response. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses. Desmopressin is also used to control bed-wetting. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Valdecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Adjust doses based on patient's diurnal pattern of response. 1 0 obj 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. 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. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. Prednisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Use combination with caution and monitor patients for signs and symptoms of hyponatremia, which may include seizures. Objective: DDAVP Injection (desmopressin acetate) is a man-made form of a hormone that occurs naturally in the pituitary gland used to treat hemophilia A or von Willebrand's disease Type I, and is also used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma. 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. September, 2004 Hospira 2004 EN-0511 Printed in USA HOSPIRA, INC., LAKE FOREST, IL 60045 USA. Piroxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. In general, most reported clinical experience with desmopressin has not identified efficacy response differences between geriatric and younger patients. Bioavailability was estimated using AUC(0-->t) for the oral and the intravenous periods. 3 0 obj Repeat dosing is not recommended due to tachyphylaxis. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. The distribution of the drug is unknown, and it is not clear whether desmopressin crosses the placenta. 4 0 obj Factors associated with mortality of myxedema coma: report of eight cases and literature survey. 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. documenting the conversion using the "IV to PO conversion" category. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Careful fluid intake restrictions are required in pediatric patients to prevent hyponatremia and water intoxication. Confirm responsiveness before using desmopressin for therapeutic interventions. A woman who took both desmopressin and ibuprofen was found in a comatose state. 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. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Do not dilute DDAVP Injection for the Diabetes Insipidus population. A woman who took both desmopressin and ibuprofen was found in a comatose state. The mean (+/- S.D.) Intermittently during treatment, assess serum sodium, urine volume and osmolality or plasma osmolality. 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. Monitor renal function and clinical status closely during use. A woman who took both desmopressin and ibuprofen was found in a comatose state. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses. <> In general, desmopressin is contraindicated in persons with heart failure or uncontrolled hypertension because fluid retention increases the risk for worsening of underlying conditions that are susceptible to volume status. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. [61810], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. Budesonide; Glycopyrrolate; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. 4. [33605], Initially, 10 mcg (0.1 mL) intranasally into 1 nostril, may increase to 30 mcg until the patient can sleep for an adequate period of time without incidence of polyuria. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. During the initial titration period and continued therapy, observe and monitor closely. Monoamine oxidase inhibitors: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia and SIADH including monoamine oxidase inhibitors (MAOIs). HHS Vulnerability Disclosure, Help Unauthorized use of these marks is strictly prohibited. Triamterene; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. In the elderly, careful fluid intake restrictions are required to prevent hyponatremia and water intoxication. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Desmopressin is a synthetic analog of vasopressin used to reduce renal excretion of water in central diabetes insipidus and nocturia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Consider other treatment options for this condition. %f2fDWBRex1*s GZhlNx;hI>l!dKc:cmEg2&M*?*q$|sa[`ov#1q=[`0GP/==g5>dof?N~;1Y This is probably due to saturation of receptor sites. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. IV infusion . Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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 previously recommended dose: 20 mcg (0.2 mL) intranasally of the 0.01% nasal solution at bedtime, with one-half of the dose administered into each nostril. The patient should close the open nostril with a finger from the empty hand and gently inhale while the nasal applicator is pumped 1 time. Ensure that serum sodium is normal prior to initiating or resuming treatment with DDAVP Injection. Amlodipine; Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Usual dilution: 0.1 mcg/mL. Many persons with type 2 vWD do not respond to desmopressin and require alternate treatment; however, a desmopressin trial can help confirm diagnosis and may be useful in some instances of mild bleeding in persons with type 2 vWD. Desmopressin. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. (Synthetic analog of vasopressin-posterior pituitary hormone). Monitor blood pressure during desmopressin administration, particularly in persons with coronary artery disease (insufficiency) and/or hypertension; desmopressin may cause hypotension (with compensatory increase in heart rate) or hypertension. Medically reviewed by Drugs.com. BJU Int. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Mefenamic Acid: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. endobj Although rare, chlorpropamide has caused a reaction identical to symptom of inappropriate antidiuretic hormone (SIADH). Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Hvistendahl GM, Riis A, Nrgaard JP, Djurhuus JC. Careers. IV: 0.3 mcg/kg once slowly over 15-30 minutes. What is the difference in Nocdurna dosage between men and women. If used preoperatively, administer 2 hours before surgery. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Blood pressure and pulse should be monitored during infusion. The recommended maintenance dose is 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. When switching from DDAVP Nasal Spray to DDAVP Injection, the starting dose is one-tenth times the DDAVP Nasal Spray dose. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Persons with vWD subtype 1C, which is characterized by a shorted vWF half-life, may require alternative management in the setting of surgery. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 0.3 mcg/kg/dose (Max: 20 mcg/dose) IV once. 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. If used preoperatively, administer 2 hours before surgery. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Lidocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. June 30, 2022 by . Caution should be used when coadministering these agents. If the product has not been used for more than 3 days, re-prime by pumping 2 actuations into the air.Instruct the patient to blow their nose, tilt the head back slightly, and insert the nasal applicator into the left or right nostril, keeping the nasal applicator upright. 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. They should also avoid drinks containing caffeine and alcohol before bedtime. 150 mcg into each nostril once for a total dose of 300 mcg. Peak plasma concentration (Cmax) was 6.2 (5.1-7.5) pg/ml at night and 6.6 (5.5-7.9) pg/ml in the daytime. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Einstein (Sao Paulo). The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Esomeprazole: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The initial response is reproducible if desmopressin is given every 2 to 3 days. Treatment has been given safely to pediatric patients for up to 6 months. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. Chlorpromazine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including chlorpromazine. DrugBank Accession Number. 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. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. 2022 Mar 2;12(3):389. doi: 10.3390/biom12030389. Fifteen healthy men aged 55-70 years were included in the analysis. 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. 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. Indications and dose Diabetes insipidus, treatment By mouth Child 1-23 months Initially 10 micrograms 2-3 times a day, adjusted according to response; usual dose 30-150 micrograms daily. Desmopressin is in a class of medications called hormones. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Valsartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. For All Patients Receiving Repeated Doses: Patients changing from intranasal desmopressin: We comply with the HONcode standard for trustworthy health information. Reassess patient after the initial 24 hours; if clinical status has improved may begin gradually tapering the dose. Desmopressin acetate 100 microgram Tablet Active Ingredient: desmopressin acetate Company: Aspire Pharma Ltd See contact details ATC code: H01BA02 About Medicine Prescription only medicine Healthcare Professionals (SmPC) Patient Leaflet (PIL) This information is for use by healthcare professionals Last updated on emc: 02 Mar 2022 Quick Links A woman who took both desmopressin and ibuprofen was found in a comatose state. All Rights Reserved. Losartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Diclofenac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10 th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses Hemophilia A and von Willebrand's Disease (Type I):
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