Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Terminal half-life was longer at night than in the daytime, but the difference is considered too small to be of clinical importance. 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. You may require 10 to 20 times a greater dose of desmopressin with the tablet oral formulations than with the nasal formulations. Initially, 0.2 mg PO once daily at bedtime. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. In infants, doses less than 5 mcg (0.05 mL) may be necessary. 4 0 obj Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 1:2. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Fluid restrictions should be observed. 2005 Oct;27(5):655-65. doi: 10.1097/01.ftd.0000168293.48226.57. It is chemically defined as follows: Mol. Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. After a 300 mcg intranasal dose of desmopressin levels of Factor VIII and vWF remain greater than 30 units/dL for 8 hours. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. 1/10 of intranasal dose; restrict fluid intake nocturnal enuresis This medication helps to control increased thirst and too much urination due to these conditions . Closely monitor serum sodium levels and urine output; fluid restriction is recommended. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Adjust doses based on patient's diurnal pattern of response. National Library of Medicine Desmopressin | Drugs | BNF | NICE Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. 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. Metoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Diabetes Insipidus: < 12 years: No definitive dosing available. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Indomethacin: (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 Diclofenac; Misoprostol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. 0.3 mcg/kg/dose (Max: 20 mcg/dose) IV once. -, Br J Urol. Desmopressin: MedlinePlus Drug Information Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Dosage form: injection Drug class: Antidiuretic hormones Medically reviewed by Drugs.com. DDAVP ( desmopressin) is a synthetic analog of vasopressin (antidiuretic hormone) that promotes release of factor VIII Reversing anticoagulation and achieving hemostasis after cardiopulmonary bypass Median time to reach Cmax (tmax) was 1.5 (range 1.0-4.1) h at night and 1.5 (range 0.5-3.0) h in the day. PDF Converting oral to intravenous or subcutaneous infusions - APPM 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. Trauma Surg Acute Care Open. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Chlorpheniramine; 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. 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. 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. 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. 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). Caution should be used when coadministering these agents. Guidelines describe preemptive desmopressin administration to prevent sodium overcorrection. The distribution of the drug is unknown, and it is not clear whether desmopressin crosses the placenta. Cyclizine SC or IV Nausea and vomiting 0.5 1 14.5 0 Diamorphine$ SC or IV Pain 0.075 0.1 2.175 2.9 1.45 3.2625 Diazepam PR Agitation, convulsions 10 Hydrocortisone IV Anaphylaxis 2 4 58 116 Hyoscine hydrobromide SC or IV Respiratory tract secretions 0.01 0.01 0.29 0.29 Midazolam SC or IV Anxiety or agitation 0.06 0.1 1.74 2.9 2 4.5 Last updated on Apr 7, 2022. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. IV: 0.3 mcg/kg once slowly over 15-30 minutes. 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. 1 to 2 mcg subcutaneously twice a day or Desmopressin is not recommended for use in persons with increased intracranial pressure or those with a history of urinary retention. Adjust for an adequate diurnal rhythm of urine output. Desmopressin nasal sprays may not be substituted for each other due to significant differences in concentration. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. A woman who took both desmopressin and ibuprofen was found in a comatose state. 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. Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. Dosing: Diabetes Insipidus Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. -. DDAVP, Minirin, Nocdurna, Stimate, +2 more. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Opiate Agonists: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including opiate agonists. Demeclocycline: (Major) The antidiuretic response to desmopressin or vasopressin (ADH) may be reduced in patients concomitantly receiving demeclocycline. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. Study results show the C max of IV acetaminophen is 76% greater than PO and 256% greater than PR. Dose should be reduced. 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. After oral desmopressin, concentrations above the limit of quantification (2.5 pg/ml) were only detected in 51% of the samples. Desmopressin Oral: Uses, Side Effects, Interactions, Pictures - WebMD Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. Desmopressin intranasal solution availability - Pituitary For bleeding, desmopressin increases the blood levels of factor VIII and von Willebrand . Desmoperssin is the drug of choice for treatment of central diabetes insipidus and most commonly it is used as intranasal spray. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Accessibility Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. Oral: 0.05 mg twice a day. Intranasal and intravenous administration of desmopressin: effect on F Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. -, Br J Urol. Maintenance dose range: 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. %f2fDWBRex1*s GZhlNx;hI>l!dKc:cmEg2&M*?*q$|sa[`ov#1q=[`0GP/==g5>dof?N~;1Y Desmopressin acts similarly to native vasopressin. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Although rare, chlorpropamide has caused a reaction identical to symptom of inappropriate antidiuretic hormone (SIADH). The pump will stay primed for up to 1 week. 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. Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. 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. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. Which lab value should prompt the nurse to question a medication dosage increase? Clin Endocrinol (Oxf). Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Saint-Prex, Switzerland - 21 June, 2022 - Minirin (desmopressin) Nasal Spray 0.1 mg/ml room temperature stable (RTS)/ Octostim (desmopressin) Nasal Spray 1.5 mg/ml/ DDAVP (desmopressin acetate, 10 mcg/0.1 mL)/ Stimate (desmopressin acetate, 1.5 mg/1 mL) Nasal Spray/ Generic Desmopressin Acetate (10 mcg/0.1mL) Nasal Spray - Recall and Production Hold Statement 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. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. According to the Beers Criteria, desmopressin is considered a potentially inappropriate medication (PIM) in geriatric adults and avoidance is recommended for treating nocturia or nocturnal polyuria because there is a high risk of hyponatremia and safer alternatives are available. Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. Individualize dosing to prevent an excessive decrease in plasma osmolality, which can lead to hyponatremia and possible seizures. Single-dose administration has been used for uremic bleeding in patients with renal failure; however, repeat doses are not recommended. PDF Intravenous Medication Guidelines for Adults - VCHCA Desmopressin is not indicated for persons with severe classic vWD (type 1), for the treatment of hemophilia B, or in persons with factor VIII antibodies. Methods: These highlights do not include all the information needed to use DDAVP R8cxz. Budesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. DDAVP Nasal SprayDDAVP nasal spray delivers doses in 0.1 mL (10 mcg) increments. Desmopressin is administered orally, intranasally, or parenterally (intravenous or subcutaneously). Ensure the patient is compliant with fluid restrictions and intake. 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Store refrigerated 2 to 8C (36 to 46F). Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). Dose range is 0.1 to 0.8 mg daily. xTMk1?DFh!PiHhmz(=lk;p"v< Fobt7t?@IFT];XaYV={~w ^JLAIIG\G\m$XJe@xH8!ZDhrN*'VH4'J.cq 'A%;v}q+i+&L 44qDxR)o3 The initial response is reproducible if DDAVP is administered every 2 to 3 days. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Repeat administration should be determined by laboratory response and clinical condition of the patient. [42295], 2 to 4 mcg IV or subcutaneously given in 1 or 2 divided doses daily. Children more than 12 years of age: Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Acetaminophen; Chlorpheniramine; 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. Please enable it to take advantage of the complete set of features! Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Amlodipine; 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. Preserve in tight containers, protected from light. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Amiloride; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Administration of intranasal desmopressin may be compromised by nasal mucosa changes (e.g., nasal trauma, nasal surgery, nasal blockage, nasal mucosal atrophy, congestion, or severe atrophic rhinitis), cranial surgery, and nasal packing.