Brand Name :
DDAVP, Noctiva, Minirin, Stimate, Nocdurna
Synonyms :
desmopressin
Class :
Vasopressin-related
Dosage forms & Strengths:
Adult:
Solution for injection
4 mcg/ml
Tablet
0.1 mg
0.2 mg
Nasal spray
0.1 mg/ml
1.5 mg/ml
Sublingual tablet
27.7 mcg
55.3 mcg
Solution for injection
4 mcg/ml
Tablet
0.1 mg
0.2 mg
Nasal spray
0.1 mg/ml
1.5 mg/ml
Refer to the adult dosing
may enhance the serum concentration of CYP3A4 inhibitors
may have an increased risk of hypertension when combined with desmopressin
may increase the hyponatremic effect of corticosteroids
may increase the hyponatremic effect of corticosteroids
may increase the hyponatremic effect of corticosteroids
may increase the hyponatremic effect of corticosteroids
may increase the hyponatremic effect of corticosteroids
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
desmopressin: they may increase the hyponatremic effect of corticosteroids
may decrease the therapeutic effect when combined with desmopressin
may increase the hyponatremic effect of hyponatremia-associated agents
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
may have an increased hyponatremic effect when combined with desmopressin
it may diminish the excretion rate when combined with gadofosveset, resulting in an enhanced serum level
it may diminish the excretion rate when combined with pentastarch, resulting in an enhanced serum level
desmopressin has the potential to reduce the rate of excretion of idebenone, leading to an elevation in levels of serum
desmopressin: they may increase the toxic effect of opioid drugs
desmopressin: they may increase the toxic effect of opioid drugs
desmopressin: they may increase the toxic effect of opioid drugs
desmopressin: they may increase the toxic effect of opioid drugs
may increase the risk or severity of hypertension when combined
may increase the hyponatremic effect of Opioid Agonists
may increase the hyponatremic effect of Hyponatremia-Associated Agents
Actions and Spectrum:
desmopressin works by increasing the amount of water reabsorbed by the kidneys, which helps to reduce urine output and increase blood concentration.
>10%:
Dry mouth (14%)
1-10%
Headache (2-5%)
Dizziness (3%)
Hyponatremia (3%)
Epistaxis (2-3%)
Frequency Not Defined:
Increased heart rate
Flushing
Water intoxication syndrome
Seizure (rare)
Allergic reaction (acute)
Anaphylaxis (rare)
Increased blood pressure
Black Box Warning:
It is essential to follow the dosage and administration instructions for the medication carefully.
Contraindication/Caution:
desmopressin is contraindicated in patients with hyponatremia (low blood sodium levels) and in patients with a history of hyponatremia caused by desmopressin.
The medication should be taken with care in patients with history of heart failure, fluid retention, or hypertension, as well as in patients taking medications that can cause fluid retention.
Additionally, desmopressin should be used with caution in patients with diabetes mellitus, as it can cause an increase in blood sugar levels. desmopressin is contraindicated in patients having seizures.
Pregnancy consideration:
No proper and well-controlled studies on the drug dose are performed on pregnant females.
Breastfeeding warnings:
Small amounts of desmopressin are found in breast milk. But is least absorbed orally by the infant.
Pregnancy category:
Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: No data is available for the drug under this category.
Pharmacology
desmopressin acts as a vasopressin receptor agonist, binding to V2 receptors in the kidney to increase water reabsorption and decrease urine output.
Pharmacodynamics:
desmopressin is a synthetic analog of the naturally occurring hormone arginine vasopressin (AVP). It acts as a vasopressin receptor agonist, binding to V2 receptors in the kidney to increase water reabsorption and decrease urine output.
desmopressin has a high affinity for V2 receptors and produces antidiuretic effects by increasing water reabsorption in the renal collecting tubules. This results in a decrease in urine output and an increase in plasma osmolality.
desmopressin also has a weak vasoconstrictive effect on blood vessels, mediated by V1 receptors. However, this effect is not clinically significant.
Pharmacokinetics:
Pharmacokinetics studies how a drug is absorbed, distributed, metabolized, and eliminated by the body. The following parameters can describe the pharmacokinetics of desmopressin.
Absorption
Bioavailability- 100% for injectable
Peak plasma is achieved in 1-5 hours
Distribution
The volume of distribution is 26.5L
Metabolism
desmopressin is metabolized by peptidases, including aminopeptidase, dipeptidyl-peptidase IV, and neutral endopeptidase.
Elimination and excretion
The half-life of desmopressin is 3.3-3.5 hours.
52% of the drug is excreted in urine.
Administration:
The medication is administered as a slow infusion for 15-30 minutes.
It is also used as a nasal spray. Do not shake the bottle.
The sublingual tablets can be taken by placing the same under the tongue. Keep the tablet for 1 hour before bedtime. Avoid alcohol and caffeine at night.
Patient information leaflet
Generic Name: desmopressin
Pronounced: des-moh-pres-in
Why do we use desmopressin?
desmopressin is used to treat diabetes insipidus, nocturia, nocturnal enuresis, and hemophilia A.
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