Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Serum concentrations of potassium, sodium, and creatinine do not change following the administration of desmopressin, and urinary excretion of potassium and sodium also remains the same. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. Children younger than 12 years of ageUse and dose must be determined by your doctor. doi: 10.1136/tsaco-2021-000852. May repeat dose if needed. Intranasal RouteApproximately 3% to 4% of an intranasally administered dose is absorbed across the nasal mucosa. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Intranasal desmopressin has an antidiuretic effect of about one-tenth that of an equivalent dose administered by injection. Do not transfer any remaining solution to another bottle. endobj Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Last updated on Apr 7, 2022. PDF Information for Patients & Parents / Carers - North Tees and Hartlepool An official website of the United States government. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 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. In a male subject with mild Von Willebrand (vW) disease, intravenous infusion of DDAVP 2 hours after administration of oral tolvaptan did not produce the expected increases in vW Factor Antigen or Factor VIII activity. 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. Some have suggested an initial dosage range of 0.1 to 1 mcg in 1 or 2 divided doses. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Nonsteroidal antiinflammatory drugs: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 8-10 mg IV = 40 mg PO. Copyright 2021 GlobalRPH - Web Development by, The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. Heparin: (Minor) Desmopressin has been shown to have an additive effect on the anticoagulant activity of heparin. The concentration-time curve after 2 microg intravenous desmopressin was best described using a biexponential term. 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. For patients who have been controlled on intranasal desmopressin acetate and who must be switched to the injection form, either because of poor intranasal absorption or because of the need for surgery, the comparable antidiuretic dose of the injection is about one-tenth the intranasal dose. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. Diabetes Insipidus: < 12 years: No definitive dosing available. Monitor renal function and clinical status closely during use. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Idiopathic partial central diabetes insipidus. 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diflunisal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. Chlorpropamide: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including chlorpropamide. 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. Maximal dose-response increase in Factor VIII activity occurs at 0.3 to 0.4 mcg/kg desmopressin. PDF Last Approval Date: Policy Title: Pharmacist-Managed Intravenous to However, individualized dosing is recommended due to high inter-patient variability in response. 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. 8600 Rockville Pike Confirm responsiveness before using desmopressin for therapeutic interventions. new homes for sale edmonton north personal chef near los angeles, ca personal chef near los angeles, ca The pump will stay primed for up to 1 week. The initial response is reproducible if DDAVP is administered every 2 to 3 days. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin has also been used in congenital or acquired bleeding disorders, including drug-induced platelet dysfunction (e.g., aspirin, dextran, ticlopidine, and heparin). The time to reach maximum plasma desmopressin levels is 0.9 hours. desmopressin iv to po conversion - MedHelp 2022 Mar 2;12(3):389. doi: 10.3390/biom12030389. In this study, efficacy and side effects of oral desmopressin. Desmopressin | Davis's Drug Guide for Rehabilitation Professionals | F 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. National Library of Medicine 50 kg or less: 150 mcg Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Tricyclic antidepressants: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including tricyclic antidepressants. Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Oral bioavailability: the amount of drug that enters systemic circulation when that drug is consumed orally. 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. Intranasal desmopressin 300 mcg results in maximal Factor VIII and von Willebrand Factor activity levels 150% to 250% of normal. 1999 Dec;84 Suppl 1:5-8 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. -, BJU Int. eCollection 2022. 0.3 to 0.4 mcg/kg/dose IV or subcutaneously once. Caution should be used when coadministering these agents. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. IV: 1 to 2 mcg twice a day Oral: 0.05 mg twice a day. Piroxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. A woman who took both desmopressin and ibuprofen was found in a comatose state. DDAVP (2 micrograms IV q8hr) is started immediately and continued until the sodium is close to normal. 3 0 obj This increase is dose-dependent, with an IV dosage of 0.4 mcg/kg producing a 300% to 400% maximum increase in Factor VIII activity. 0.3 mcg/kg/dose (Max: 20 mcg/dose) IV once. 0.1 to 0.4 mL via rhinal tube intranasally twice a day. <> 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. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient. Fluid intake restrictions in these patients are recommended. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. For the treatment of hypothyroidism of any etiology, except during the recovery phase of subacute thyroiditis; used as a replacement in primary (thyroidal), secondary (pituitary), tertiary (hypothalamic), congenital (cretinism), or acquired hypothyroidism. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. For All Patients Receiving Repeated Doses: Patients changing from intranasal desmopressin: We comply with the HONcode standard for trustworthy health information. In the elderly, careful dosage selection and monitoring of renal function are recommended. Initiate fluid restriction during treatment with DDAVP Injection [see Warnings and Precautions (5.1), Use in Specific Populations (8.4, 8.5)]. 1990 Aug;66(2):175-6 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. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. YES. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Consider other treatment options for this condition. Two children with diabetes insipidus had decreasing desmopressin requirements with lamotrigine initiation. I would recommend making an appointment with your regular doctor to see what might be causing this. Einstein (Sao Paulo). The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. Diclofenac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Children more than 12 years of age: Do not use desmopressin as sole therapy in persons with vWD undergoing major surgery. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Cortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. Oral doses of 0.2 and 0.4 mg produce similar responses on urine volume and urine osmolality as 0.01 mg and 0.02 mg intranasal doses. Desmopressin is found in breast milk, but not in significant amounts. Desmopressin is similar to a hormone that is produced in the body. Children more than 12 years of age: Desmopressin Acetate Injection, USPFor Intravenous or - DailyMed government site. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Desmopressin nasal sprays may not be substituted for each other due to significant differences in concentration. [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. Azelastine; Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. DDAVP Nasal Spray (desmopressin acetate) Rx only DESCRIPTION DDAVP Nasal Spray (desmopressin acetate) is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin (ADH), an antidiuretic hormone affecting renal water conservation. Ethacrynic Acid: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Desmopressin acetate 100 microgram Tablet - medicines The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Tolvaptan: (Major) Coadministration of tolvaptan and desmopressin (DDAVP) is not recommended. May repeat dose after 8 to 12 hours and once daily thereafter as needed to reduce spontaneous or traumatic bleeding. DDAVP, Minirin, Nocdurna, Stimate, +2 more. 50 kg or less: 150 mcg 2022 Feb 18;14(4):1057. doi: 10.3390/cancers14041057. Carbetapentane; 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. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. The hemostatic effects of desmopressin are mediated through V2 receptor agonist activity, as patients with nephrogenic diabetes insipidus, who lack this receptor, do not have a hemostatic response to desmopressin. Levothyroxine Sodium Injection (levothyroxine sodium) dose - PDR Dependent on route of administration and indication for therapy. If the product has not been used for a period of 1 week, re-prime the pump by pressing once.Instruct patient on the proper technique for administering the nasal spray. 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. 5 to 40 mcg spray intranasally twice a day or 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. 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Tilt bottle so that the tube inside the bottle draws from the deepest portion of the medication.To avoid the spread of infection, do not use the container for more than 1 person.For 5 mL bottles, discard after 50 sprays (doses), and 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. Doses may be titrated up to 0.6 mg PO once daily at bedtime, depending on individual patient response. Bioavailability and pharmacokinetics of desmopressin in elderly men. Azilsartan; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil. Codeine; Phenylephrine; Promethazine: (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. Ther Drug Monit. Scand J Urol Nephrol Suppl. THOSE AT INCREASED RISK FOR HYPONATREMIA: 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. However, desmopressin is used off-label as a single injection for uremic bleeding in persons with renal failure. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Intranasal: 5 mcg/day as a single dose or in 2 divided doses. 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. If used to reduce spontaneous or traumatic bleeding, doses may be repeated after 8 hours to 12 hours and once daily thereafter, if needed, based upon clinical condition and von Willebrand factor and factor VIII levels. Preoperative doses may be given 2 hours prior to the scheduled procedure. desmopressin (des-moe-pres-sin) DDAVP, DDAVP Rhinal Tube, DDAVP Rhinyle Drops, Octostim, Stimate. Caution should be used when coadministering these agents. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Intranasal: These highlights do not include all the information needed to use DDAVP Conversion of IV Midazolam. For All Patients Receiving Repeated Doses: Restrict free water intake and monitor for hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. 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. 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. Budesonide; Glycopyrrolate; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. administer single spray (150 mcg) if patient >12 years of age but <50 kg body weight. Vincristine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Background. Medically reviewed by Drugs.com. CAREFULLY BEFORE ACCESSING OR USING THIS SITE. A woman who took both desmopressin and ibuprofen was found in a comatose state. Conversion from IV to PO may reduce the need for IV access, which carries a higher risk of hospital-acquired bloodstream infections, 4 phlebitis, cellulitis, and severe adverse events associated with infiltration5 for the patient. Caution should be used when coadministering these agents. Unlike nearly all other benzodiazepine conversions, the conversion between intravenous midazolam and lorazepam has been well studied in mechanically ventilated patients. *L#n~i V3{kf_t.wjO_KgImL%4+GJ+Pp QsWAd._e7p!90&z {c`Kk;swZ/Nf{s~d? Clipboard, Search History, and several other advanced features are temporarily unavailable. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Infants 3 months of age and children: Applies to the following strengths: 0.15 mg/inh; 10 mcg/inh; 4 mcg/mL; 0.1 mg; 0.2 mg; 15 mcg/mL; 0.01%; 27.7 mcg; 55.3 mcg; 0.83 mcg/0.1 mL; 1.66 mcg/0.1 mL; 15 mcg/inh. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. Vasopressin, ADH: (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 vasopressin, ADH only with careful patient monitoring. Desmopressin (dDAVP), a synthetic analogue of 8-arginine vasopressin (ADH), is an antidiuretic . Infants 3 months of age and children: 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. Study results show the C max of IV acetaminophen is 76% greater than PO and 256% greater than PR. 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. Desmopressin | Drugs | BNF | NICE 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. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. Desmopressin (Injection Route) Proper Use - Mayo Clinic Vasopressin also causes constriction of vascular smooth muscle and contraction of smooth muscle in the GI tract and uterus. 1. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Methods: The study had an open, randomised, four-way cross-over design. Desmopressin is also used to control bed-wetting. Carbinoxamine; 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. wt. Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. On Days 1, 3 and 5, subjects were dosed intranasally with escalating doses of AV002 nasal spray. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Telmisartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Med Surg ATI Proctored Exam Test Bank A 1 Medication therapies A nurse cares for a client receiving vancomycin IV therapy. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. If the patient was previously receiving desmopressin tablets, dose titration is required because intranasal desmopressin is approximately 10 to 40 fold more potent than oral (tablet) desmopressin. When switching from DDAVP Tablets to DDAVP Injection, titrate dose individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) due to the large variability in both PK and PD. 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. Blood pressure and pulse should be monitored during infusion. Furosemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Commonly central DI is treated with desmopressin. Intermittent intravenous infusionFor adults and children weighing greater than 10 kg, dilute dose in 50 mL of 0.9% Sodium Chloride for injection. PDF DDAVP Injection (desmopressin acetate) - Sanofi A woman who took both desmopressin and ibuprofen was found in a comatose state. Disclaimer. Persons with vWD subtype 1C, which is characterized by a shorted vWF half-life, may require alternative management in the setting of surgery. Guaifenesin; 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. DB00035. The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. During initial titration and continued therapy, observe and monitor closely; adjust treatment to the diurnal pattern of response. 100 unit / 100 ml (1 unit/ml).