Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. News Article Holder This page will generate the the news article from the ID supplied in the URL. Dose: 0.1-1.2 mg/day PO divided bid-tid; Start: 0.05 mg PO bid; Max: 1.2 mg/day; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; restrict fluid intake [parenteral route] Dose: 2-4 mcg/day SC/IV divided qd-bid; Info: parenteral dose is approx. If administered more than once a day, adjust for an adequate diurnal rhythm of urine output. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. -. stream Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Adjust for an adequate diurnal rhythm of urine output. Which lab value should prompt the nurse to question a medication dosage increase? A woman who took both desmopressin and ibuprofen was found in a comatose state. Caution should be used when coadministering these agents. Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma. The plasma levels given by the intravenous dose resulted in a duration of action of 12 h or more. A woman who took both desmopressin and ibuprofen was found in a comatose state. FOIA Brand Names. 1.2 mg/day PO, 4 mcg/day SC/IV; Alt: 2-4 mcg/day SC/IV divided qd-bid; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; parenteral dose is approx. Decrease bleeding following cardiac bypass: 0.3 mcg/kg ivpb. Guardrail Drug Requires documentation of two (2) RN's for double-checking. A woman who took both desmopressin and ibuprofen was found in a comatose state. 1990 Aug;66(2):175-6 IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. DDAVP/Desmopressin Injection - Summary of Product Characteristics (SmPC In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended. A woman who took both desmopressin and ibuprofen was found in a comatose state. DDAVP Injection (desmopressin acetate) is a man-made form of a hormone that occurs naturally in the pituitary gland used to treat hemophilia A or von Willebrand's disease Type I, and is also used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma. Caution should be exercised when desmopressin is administered to a woman who is breast-feeding. Tachyphylaxis (lessening of response) with repeated administration (i.e., given more frequently than every 48 hours) may occur. 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. Fluticasone; Umeclidinium; Vilanterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Despite low bioavailability, the pharmacodynamic effects of oral desmopressin were similar in magnitude to those after intravenous dose at night and during the first 6 h after daytime administration. BJU Int. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Oxycodone: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. Initiate at low dose and increase as necessary. Monoamine oxidase inhibitors: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia and SIADH including monoamine oxidase inhibitors (MAOIs). The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. I don't know why you would suddenly notice a decrease in your symptoms after 34 years. 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. Proposed sites of these receptors include endothelial cells, megakaryocytes, blood monocytes, and mast cells. Desmopressin (Injection Route) Proper Use - Mayo Clinic Captopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. IV and subcutaneously: No definitive dosing available. Doses may be titrated up to 0.6 mg PO once daily at bedtime, depending on individual patient response. The recommended starting dose is 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. doi: 10.31744/einstein_journal/2023RC0124. -, Br J Clin Pharmacol. BJU Int. 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. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. Initially, 0.2 mg PO once daily at bedtime. PDF DDAVP Injection (desmopressin acetate) - Sanofi A woman who took both desmopressin and ibuprofen was found in a comatose state. 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. desmopressin (des-moe-pres-sin) DDAVP, DDAVP Rhinal Tube, DDAVP Rhinyle Drops, Octostim, Stimate. Prilocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 2 0 obj Select one or more newsletters to continue. For endotoxin-induced fever, IV is favored over PO acetaminophen in reducing temperature for up to . Torsemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. IV infusion . x}n y)Zn91Iv l38Y8bIkYbX$=x:9\>?}st_~xOo^\~dt&&=\~o~g/}~y%;]V|s{h+j/~\f'iqriwZgI~IOk[b,n6'K+%Y{Y?k{]U4{H}mWRa |3}ktz_>iCy>VbZ{SZ(_!> _~{pz.5'Kxo'wW0P*okGa? Fatal anaphylaxis has been reported with intravenous desmopressin. Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The initial and terminal half-lives for desmopressin are 7.8 and 75.5 minutes, respectively, resulting in a prompt onset of action with a long duration of action. Hemophilia A and von Willebrand's Disease (Type I): The recommended dosage is 0.3 mcg/kg actual body weight (to a maximum of 20 mcg) administered by intravenous infusion over 15 minutes to 30 minutes. This site needs JavaScript to work properly. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Desmopressin: Dosage, Mechanism/Onset of Action, Half-Life - Medicine.com %f2fDWBRex1*s GZhlNx;hI>l!dKc:cmEg2&M*?*q$|sa[`ov#1q=[`0GP/==g5>dof?N~;1Y Intranasal desmopressin 300 mcg results in maximal Factor VIII and von Willebrand Factor activity levels 150% to 250% of normal. Pretreatment Testing and On-Treatment Monitoring Diabetes Insipidus Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. When switching between formulations, the below text is meant as guidance for starting dose. Response should be estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. 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. Desmopressin is not effective in persons with type 3 von Willebrand's disease (vWD) and can cause platelet aggregation, thrombocytopenia, and possibly thrombosis in persons with type 2B vWD. anaphylactoid reactions / Rapid / 0-1.0anaphylactic shock / Rapid / 0-1.0seizures / Delayed / Incidence not knownwater intoxication / Delayed / Incidence not knowncoma / Early / Incidence not knownthrombosis / Delayed / Incidence not knownthromboembolism / Delayed / Incidence not knownstroke / Early / Incidence not knownmyocardial infarction / Delayed / Incidence not known, hyponatremia / Delayed / 0.9-12.0hypertension / Early / 1.7-2.6photophobia / Early / 0-2.0conjunctivitis / Delayed / 0-2.0confusion / Early / Incidence not knownelevated hepatic enzymes / Delayed / Incidence not knownhypotension / Rapid / Incidence not knownsinus tachycardia / Rapid / Incidence not knownpalpitations / Early / Incidence not knowninfertility / Delayed / Incidence not knownbalanitis / Delayed / Incidence not knowntolerance / Delayed / Incidence not known, xerostomia / Early / 0-14.0rhinitis / Early / 3.0-8.0headache / Early / 2.0-5.0pharyngitis / Delayed / 2.3-3.8dizziness / Early / 0-3.0epistaxis / Delayed / 2.0-3.0nasal congestion / Early / 1.4-2.9sneezing / Early / 2.3-2.6back pain / Delayed / 1.1-2.3chills / Rapid / 0-2.0asthenia / Delayed / 0-2.0rhinalgia / Early / 2.0-2.0ocular pruritus / Rapid / 0-2.0lacrimation / Early / 0-2.0diarrhea / Early / Incidence not knownabdominal pain / Early / Incidence not knowndyspepsia / Early / Incidence not knownnausea / Early / Incidence not knownlethargy / Early / Incidence not knownflushing / Rapid / Incidence not knowncough / Delayed / Incidence not knowninjection site reaction / Rapid / Incidence not knownoligospermia / Delayed / Incidence not known. This site complies with the HONcode standard for trust- worthy health information: verify here. Intranasal and intravenous administration of desmopressin: effect on F Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Preoperative doses may be given 2 hours prior to the scheduled procedure. Desmopressin is a strong V2 agonist and has no effect on V1 receptors. Desmopressin is contraindicated in persons with moderate to severe renal impairment (CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2) and renal failure. Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Doses may be titrated up to 0.6 mg PO once daily at bedtime, depending on individual patient response. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. A woman who took both desmopressin and ibuprofen was found in a comatose state. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication.[42295]. <> PDF Last Approval Date: Policy Title: Pharmacist-Managed Intravenous to endobj The Melt dose is then derived from tablet conversion, as . 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. Only start or resume therapy in patients with a normal serum sodium concentration. The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The .gov means its official. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Intranasal RouteApproximately 3% to 4% of an intranasally administered dose is absorbed across the nasal mucosa. IV: 0.3 mcg/kg once slowly over 15-30 minutes. Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. % If patients are receiving intranasal therapy, begin oral therapy 12 hours after last intranasal dose. IV: 1 to 2 mcg twice a day The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fludrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. -, BJU Int. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Einstein (Sao Paulo). For All Patients Receiving Repeated Doses: Restrict free water intake and monitor for hyponatremia. 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. 8-10 mg IV = 40 mg PO. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover.