Desmopressin

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

DDAVP (nasal spray/solution, tablets)

Drug group:

Drug for diabetes insipidus

Prescription needed?

Yes

What does it do?

Desmopressin is a synthetic form of the hormone vasopressin, and is used to treat:

• Diabetes insipidus – a condition caused by low levels of vasopressin in the body, leading to excess urine production and continual thirst
• Nocturnal enuresis (bedwetting) in both children and adults
• Haemophilia and von Willebrand’s disease – intravenous form helps to boost clotting factors

How should it be used?

• Do not take during episodes of vomiting or diarrhoea
• Avoid excessive fluid intake after taking your dose

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

Diabetes insipidus

(tablets 3 x daily; nasal spray/solution 1–2 x daily)

• Adults: tablets 300–600mcg; nasal spray 1–4 puffs; nasal solution 10–40mcg daily
• Children: tablets 300–600mcg; nasal spray up to 2 puffs; nasal solution 20mcg daily

Nocturnal enuresis

• Take at bedtime and avoid fluids from 1 hour before bedtime to 8 hours afterwards
• Tablets (adults/children>5 years) 200–400mcg; nasal sol 20–40mcg; nasal spray 2–4 puffs

How quickly will it start to work?

Some effect within a few minutes; full effects: injection, nasal solution/spray = a few hours; tablets = 30–90 minutes
                           

How long will the effects last?

Tablets = 6–12 hours; injection/nasal sol/nasal spray = 5–21 hours

When should I stop using it?

Do not stop the drug without consulting your doctor

Is it safe for prolonged use?

Diabetes insipidus: no problems expected.

Nocturnal enuresis: after 3 months of treatment, the drug should be stopped for at least a week, to assess the need to continue treatment. Blood levels of electrolytes (especially sodium) should be monitored periodically. 

What are the possible side effects?

Adverse effects with desmopressin are uncommon, but the following have been reported:

• Less common: fluid retention, low blood sodium (especially if fluid intake is high), headache, nausea, vomiting, nasal congestion, nosebleeds
• Report to your doctor before taking your next dose if you experience: seizures, stomach pain

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: heart/kidney problems, high blood pressure, cystic fibrosis, asthma, allergic rhinitis, epilepsy
• Other medicines: Antidepressants, chlorpropamide, chlorpromazine, fludrocortisone, carbamazepine, indomethacin, ibuprofen
• Pregnancy and breast-feeding: Safety not established
• Children: No special problems in children; infants may need fluid balance monitoring
• Over 60: May need monitoring to ensure that fluid balance is correct
• Driving and hazardous work: No known problems
• Alcohol: no known problems