Desmopressin
CLINICAL USE
Diabetes insipidus Nocturnal enuresis Post-biopsy bleeding (unlicensed indication)Pre-biopsy prophylaxis (unlicensed indication)
DOSE IN NORMAL RENAL FUNCTION
Diabetes insipidus: Oral: 0.2–1.2 mg daily in 3 divided doses. IV: 1–4 mcg daily. Inhaled: 10–40 mcg in 1 or 2 divided doses. Sub-lingual: 120–720 mcg dailyNocturnal enuresis: Oral: 200–400 mcg at bedtime, Biopsy: Males – 16 mcg; Females – 12 mcg or 300–400 nanograms/kg Pre-biopsy prophylaxis in uraemic patients: 20 mcg (IV) over 30 minutes
PHARMACOKINETICS
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsNone known
ADMINISTRATION
Reconstition
Dilute dose to 50 mL with sodium chloride 0.9%
Route
IV, intranasally, oral, SC, IM, SL
Rate of Administration
Over 20–60 minutes
Comments
Do not inject at a faster rate – greater risk of tachyphylaxisIn patients with ischaemic heart disease, infuse more slowly – increased risk of acute ischaemic event
OTHER INFORMATION
Emergency treatment of more generalised bleeding unresponsive to normal treatments: 0.1–0.5 micrograms/kg 4 times a day + IV conjugated oestrogens (premarin) 0.6 mg/kg/day for up to 5 days DDAVP works as a haemostatic by stimulating factor VIII production Onset of action less than 1 hour. Duration of effect 4–8 hours