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Following oral administration, the onset of antidiuretic effect occurs around 1 hour and reaches a maximum at 4 to 7 hours. Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Dependent on route of administration and indication for therapy. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Avoid spraying in the eyes. Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral desmopressin). In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. 2005 Oct;27(5):655-65. doi: 10.1097/01.ftd.0000168293.48226.57. IV: 0.3 mcg/kg once slowly over 15-30 minutes. DDAVP Rhinal TubeDDAVP Rhinal tube is used to administer desmopressin doses less than 10 mcg (less than 0.1 mL).Break the seal on the bottle and remove cap. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. 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. Initiate at low dose and increase as necessary. Usual Adult Dose for Diabetes Insipidus Initial dose: 0.05 mg orally twice a day or 1 to 2 mcg IV twice a day or 1 to 2 mcg subcutaneously twice a day or 5 to 40 mcg spray intranasally twice a day or 0.1 to 0.4 mL via rhinal tube intranasally twice a day. HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. Children more than 12 years of age: May repeat dose after 8 to 12 hours and once daily thereafter as needed to reduce spontaneous or traumatic bleeding. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Fatal anaphylaxis has been reported with intravenous desmopressin. Immune Checkpoint Inhibitors as a Threat to the Hypothalamus-Pituitary Axis: A Completed Puzzle. Desmopressin (Injection Route) Proper Use - Mayo Clinic Pharmacokinetic parameters were derived using a two-compartmental model except for AUC(0-->t), which was derived using non-compartmental analysis. Intermittently during treatment, assess serum sodium, urine volume and osmolality or plasma osmolality. 3 0 obj wt. LV>T6If7>LYJTgJ^kyf>[7Sz]>mCh^3r3a2Lmm$9_5y/;D|s }3a7+NGv46p?MISiZ?dV?pmSosEIN.6DLY}%OL!+Cuf^C;\EvwgOv|2> V,>1w|>>O[[ej,UdSg,ufiEI'&c3Y_$x_'Ifm9s;KY|{AuLTiv[V>n~>r`-@Z(^++Gj~Stsz|6jmm/1dEIz$+ZE7c0rw@GRt=%K2*#g`9'Jp?Hol+c/1K6//1-=d#~t*8t)~H0E>ue)'U'$L 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. Dextromethorphan; 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. A comparison was made of intranasal administration of 300 micrograms desmopressin (DDAVP) by spray, with intravenous administration of 0.2, 0.3 and 0.4 microgram DDAVP/kg in 10 healthy volunteers. Acetaminophen; 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. Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Oral TabletsIf converting from intranasal therapy, administer oral dose 12 hours after last intranasal dose.Patient response to each dose should be determined by adequate duration of sleep and adequate, not excessive, water turnover. Your doctor may adjust the dose as needed. . A woman who took both desmopressin and ibuprofen was found in a comatose state. 1. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. documenting the conversion using the "IV to PO conversion" category. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. DDAVP Injection (Desmopressin Acetate Injection): Uses, Dosage - RxList Furosemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Meny Lukk national monument bank uk; will arnett brothers and sisters Longer DOA. A woman who took both desmopressin and ibuprofen was found in a comatose state. Prilocaine; 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 Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Disclaimer. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Factors associated with mortality of myxedema coma: report of eight cases and literature survey. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Increased FVIII and vWF levels are thought to be due to their release from endogenous reservoirs and not increased synthesis since the response is so rapid. Valdecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin Oral: Uses, Side Effects, Interactions, Pictures - WebMD Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. 1. 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. Desmopressin: Uses, Interactions, Mechanism of Action - DrugBank Determine need for repeat dosage based on laboratory response and patient's clinical condition. Adjust for an adequate diurnal rhythm of urine output. Dilution Desmopressin (DDAVP ) - GlobalRPH Ensure the patient is compliant with fluid restrictions and intake. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. We comply with the HONcode standard for trustworthy health information. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. There is no information on the effects of desmopressin on the breast-fed infant or on milk production. Budesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Response to vasopressin is mediated through two receptors: the V1 receptor, which mediates smooth muscle contraction in the peripheral vasculature, and the V2 receptor, which regulates water resorption in the collecting ducts. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). MeSH 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. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Dosage form: injection Drug class: Antidiuretic hormones Medically reviewed by Drugs.com. Also remove sticky note when IV to po is addressed. Budesonide; Glycopyrrolate; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Select one or more newsletters to continue. Hydralazine; 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. When DDAVP /Desmopressin Injection is used for diagnostic purposes, fluid intake must be limited and not exceed 0.5 litres from 1 hour before until 8 hours after administration. Bisoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. If the product has not been used for more than 3 days, re-prime by pumping 2 actuations into the air.Instruct the patient to blow their nose, tilt the head back slightly, and insert the nasal applicator into the left or right nostril, keeping the nasal applicator upright. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Formoterol; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. [33605], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. 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. Available for Android and iOS devices. Carbetapentane; 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. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10 th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses Hemophilia A and von Willebrand's Disease (Type I): once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. [61810], 2 to 4 mcg IV or subcutaneously given in 1 to 2 divided doses daily. Promethazine; 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. In the elderly, careful dosage selection and monitoring of renal function are recommended. 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. desmopressin iv to po conversion - dthofferss.com The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. . Renal concentration capacity testing in children below the age of 1 year should only be performed under carefully supervised conditions in hospital. 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. CrCl 50 mL/minute or more: No dosage adjustment is needed.CrCl less than 50 mL/minute OR eGFR less than 50 mL/minute/1.73 m2: Use is contraindicated. Then i-Vents acuity will now have a 10 to signify there is a open i-Vent. Consider risk vs. benefit as pregnant women with Hemophilia A or von Willebrand's disease as these patients may be at an increased risk for bleeding diatheses and hemorrhagic events at delivery; affected neonates may also be at risk of bleeding diatheses. 4 0 obj 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. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. stream Prepare the solution for infusion using aseptic technique. In hemophilia A and von Willebrand disease, it should only be used for mild to moderate cases. Adjust treatment according to the diurnal pattern of response. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 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. Fluid restrictions should be observed. What is the difference in Nocdurna dosage between men and women. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Lamotrigine: (Major) Caution is recommended if a drug that may increase the risk of water intoxication with hyponatremia, such as lamotrigine, is administered with desmopressin acetate. About 1/4 to 1/3 of patients can be controlled by a single daily dose. Blood samples were taken before and at predetermined time points up to 12 h after dosing. Put the other end of the tube into the patients mouth; the patient should hold their breath.Tilt the patient's head back and have them blow with a short strong puff through the tube. WBC count of 3,000mm 3. Generic:- Closed containers will maintain stability for 3 weeks at controlled room temperature (68 to 77 degrees F)- Refrigerate (between 36 and 46 degrees F)DDAVP:- Discard product if it contains particulate matter, is cloudy, or discolored- Store in refrigerator at 2 to 8 degrees C (36 to 46 degrees F)Minirin:- Store at 77 degrees F; excursions permitted to 59-86 degrees F- Store uprightNocdurna:- Product should always be stored in the blister and only removed immediately before use- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in the original carton to protect from lightNoctiva:- Product must be used within 60 days after removal from refrigeration to room temperature (77 degrees F)- Store in refrigerator (36 to 46 degrees F), excursions permitted between 32 to 59 degrees F- Store uprightStimate:- Store at room temperature (up to 77 degrees F)- Store upright. Urine, for measurements of volume and osmolality, was collected in predetermined intervals before and until 12 h after dosing. 50 kg or less: 150 mcg Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Confirm responsiveness before using desmopressin for therapeutic interventions. Adjust dose based upon response to treatment estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. 1/10 of intranasal dose . A woman who took both desmopressin and ibuprofen was found in a comatose state. In addition, in vitro studies with human placenta demonstrate poor placental transfer of desmopressin. Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. -The most preferred drug is desmopressin acetate (DDAVP), a synthetic form of vasopressin given orally, as a sublingual "melt," or intranasally in a metered spray. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Preoperative doses may be given 2 hours prior to the scheduled procedure. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient. The time to reach maximum plasma desmopressin levels is 0.9 hours. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Celecoxib; Tramadol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Consider other treatment options for this condition. The necessity for repeat administration of desmopressin acetate or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. Noctiva Nasal SprayNoctiva nasal spray delivers either 0.83 mcg or 1.66 mcg of desmopressin acetate (equivalent to 0.75 mcg or 1.5 mcg of desmopressin) per spray (0.1 mL).Two sprays of the 0.83 mcg nasal spray are not interchangeable with 1 spray of the 1.66 mcg nasal spray; the 1.66 mcg/0.1 mL nasal spray should be prescribed for patients who are or will be taking the 1.66 mcg dose.Do NOT shake the bottle.Prime the nasal spray before using for the first time by pumping 5 actuations into the air away from the face. 1 to 2 mcg IV every 6 to 8 hours in combination with hypertonic saline. IV and subcutaneously: No definitive dosing available. As of 2007 in response to a FDA request for removal of the indication, the intranasal formulation is no longer indicated for the treatment of primary nocturnal enuresis secondary to post-marketing reports of hyponatremic-related seizures, which most often occurred in pediatric patients. Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Dexamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. A woman who took both desmopressin and ibuprofen was found in a comatose state. Benazepril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Desmopressin acetate | CHEO ED Outreach Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Fosinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Drug class: Antidiuretic hormones. For endotoxin-induced fever, IV is favored over PO acetaminophen in reducing temperature for up to . Tilt bottle so that the tube inside the bottle draws from the deepest portion of the medication.If given preoperatively, intranasal desmopressin should be administered 2 hours before surgery.To avoid the spread of infection, do not use the container for more than 1 person.Discard spray pump after 25 sprays since the amount delivered thereafter per spray may be substantially less than the recommended dose. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. Desmopressin is found in breast milk, but not in significant amounts. -, Br J Urol. Cisplatin can cause hyponatremia, which may increase the risk of water intoxication in patients receiving treatment with desmopressin. Olopatadine; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin was administered orally (0.2 mg) and intravenously (2 microg), daytime and night-time, yielding four in-hospital sessions, separated by at least 2 days. If 30 mcg is divided, typically 20 mcg is given in the morning, and 10 mcg is given at night. 2022 Mar 8;7(1):e000852. 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. 1/10 of intranasal dose; restrict fluid intake nocturnal enuresis The administration of carbamazepine prior to administration of desmopressin may act to reduce the duration of action of desmopressin. Generic Name. The concentration-time curve after 2 microg intravenous desmopressin was best described using a biexponential term. A desmopressin response requires an increase of at least 2 times the baseline von Willebrand factor (vWF) activity and an increase of both vWF and factor VIII concentrations of more than 0.5 International Units/mL for at least 4 hours. After oral desmopressin, concentrations above the limit of quantification (2.5 pg/ml) were only detected in 51% of the samples. endobj Losartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Sulindac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Reassess patient after the initial 24 hours; if clinical status has improved may begin gradually tapering the dose. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. 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. 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. 55.3 mcg sublingually once daily, 1 hour before bedtime without water. 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. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day.