Treatment has been given safely to pediatric patients for up to 6 months. administration route. <> The resultant increases in FVIII and vWF are similar to those seen with replacement therapy using blood products. It is chemically defined as follows: Mol. 3 0 obj This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. 150 mcg into each nostril once for a total dose of 300 mcg. Bioavailability and pharmacokinetics of desmopressin in elderly men. News Article Holder This page will generate the the news article from the ID supplied in the URL. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. . endobj If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. A Resource To Help With Changing From IV To PO Antibiotics Repeat dosing is not recommended; therefore, the risk of toxicities associated with accumulation of desmopressin is expected to be low, especially with single-dose intermittent use and appropriate monitoring. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. Hydrocortisone (systemic): Drug information - UpToDate The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmoperssin is the drug of choice for treatment of central diabetes insipidus and most commonly it is used as intranasal spray. how do you switch from labetalol IV to PO. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. Maintenance dose range: 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. IV Push for Hyperkalemia. Bioavailability was estimated using AUC(0-->t) for the oral and the intravenous periods. Desmopressin is administered intravenously or subcutaneously.Desmopressin (DDAVP) injection has an antidiuretic hormone activity of 16 International Units/mL; 1 mcg desmopressin is equivalent to 4 International Units antidiuretic hormone activity.If given preoperatively, desmopressin injection should be given 30 minutes before the scheduled procedure.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Caution should be used when coadministering these agents. 2022 Feb 18;14(4):1057. doi: 10.3390/cancers14041057. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses. 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. IV infusion IV Infusion IV Infusion (OB) Only REGULAR insulin may be administered by the IV route. DOSAGE AND ADMINISTRATION Hemophilia A and von Willebrand's Disease (Type I): Desmopressin Acetate Injection 4 mcg/mL is administered as an intravenous infusion at a dose of 0.3 mcg desmopressin acetate/kg body weight diluted in sterile physiological saline and infused slowly over 15 to 30 minutes. June 30, 2022 by . R8cxz. <> 27.7 mcg sublingually once daily, 1 hour before bedtime without water. 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. Doses may be titrated up to 0.6 mg PO once daily at bedtime, depending on individual patient response. Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task. 50 kg or less: 150 mcg Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with 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. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Intranasal desmopressin 300 mcg results in maximal Factor VIII and von Willebrand Factor activity levels 150% to 250% of normal. 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. Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Median time to reach Cmax (tmax) was 1.5 (range 1.0-4.1) h at night and 1.5 (range 0.5-3.0) h in the day. Severe allergic reactions, including anaphylaxis, have been reported with intravenous and intranasal desmopressin. Dose range is 5 to 30 mcg/day. Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Ther Drug Monit. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. In the elderly, careful dosage selection and monitoring of renal function are recommended. For All Patients Receiving Repeated Doses: Patients changing from intranasal desmopressin: We comply with the HONcode standard for trustworthy health information. Demeclocycline: (Major) The antidiuretic response to desmopressin or vasopressin (ADH) may be reduced in patients concomitantly receiving demeclocycline. 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. 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. 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 is found in breast milk, but not in significant amounts. Gently breathe in through the nose and out through the mouth several times.Wipe the nasal applicator using a clean tissue and replace the cap on the bottle.To avoid the spread of infection, do not use the container for more than 1 person.Do not co-administer with other intranasal products.Discard nasal spray 60 days after opening. Children more than 12 years of age: Use desmopressin nasal spray for nocturia with caution and monitoring of blood volume status in persons with New York Heart Association Class I congestive heart failure. PDF DDAVP Injection (desmopressin acetate) - Sanofi Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. If patients are receiving intranasal therapy, begin oral therapy 12 hours after last intranasal dose. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin acetate | CHEO ED Outreach Preoperative doses may be given 2 hours prior to the scheduled procedure. No adverse developmental outcomes were observed in animal reproduction studies with administration of desmopressin during organogenesis to pregnant rats and rabbits at doses approximately less than 1 and 38 times, respectively, the maximum recommended human dose based on body surface area (mg/m2). Formoterol; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The frequency of dosing varies with patient responses. 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. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. May repeat dose after 8 to 12 hours and once daily thereafter as needed to reduce spontaneous or traumatic bleeding. So, if a patient is on a nasal (spray or intranasal) dose of 10mcg (0.1 ml) twice a day, then a suitable tablet oral dose may be 100mcg or 200mcg twice a day. Individualize dosing to prevent an excessive decrease in plasma osmolality, which can lead to hyponatremia and possible seizures. A woman who took both desmopressin and ibuprofen was found in a comatose state. Decompensated Hypothyroidism ("Myxedema Coma") - EMCrit Project A woman who took both desmopressin and ibuprofen was found in a comatose state. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. A woman who took both desmopressin and ibuprofen was found in a comatose state. Blood samples were taken before and at predetermined time points up to 12 h after dosing. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. The following pharmacist will check on these open i-Vents and close then when appropriate. The administration of carbamazepine prior to administration of desmopressin may act to reduce the duration of action of desmopressin. Maintenance dose range: 10 mcg/day to 30 mcg/day intranasally (0.1 mL/day to 0.3 mL/day) in 1 to 2 divided doses. A systematic review of 30 studies of desmopressin for the treatment and prophylaxis of bleeding disorders in pregnancy (n = 216) concluded that the drug is effective in reducing bleeding complications associated with pregnancy and childbirth with a good safety record. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The risk of toxic reactions (including water intoxication and low sodium concentrations) appears to be greater in the geriatric patient and other patients with impaired renal function. Oral to IV Conversion: The intravenous dose of levothyroxine is not the same as the oral dose. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Mefenamic Acid: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. The recommended maintenance dose is 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. Dependent on route of administration and indication for therapy. May repeat dose if needed. 55.3mcg of desmopressin acetate (equivalent to 50 mcg of desmopressin) Diabetes Insipidus Intranasal (DDAVP) Indicated as antidiuretic replacement therapy in the management of central cranial. 1 to 2 mcg IV every 6 to 8 hours in combination with hypertonic saline. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. During the initial titration period and continued therapy, observe and monitor closely. Desmopressin - FPnotebook.com 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. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. 1998 Nov;82(5):642-6 Generic Name. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. Background. Valdecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin (DDAVP) in the Treatment of Bleeding Disorders: The First [33605], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. Olopatadine; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. This site needs JavaScript to work properly. Treatment nave patients: The recommended starting daily dosage is 2 mcg to 4 mcg administered as one or two divided doses by subcutaneous or intravenous injection. When desmopressin is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular pediatric and geriatric patients, fluid intake should be adjusted downward to decrease to potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain). Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. For continuous infusions, conc. 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. Desmopressin - UpToDate 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. Every 3 months, When switching between formulations, the below text is meant as guidance for starting dose. 1995 Apr;42(4):373-8. doi: 10.1111/j.1365-2265.1995.tb02645.x [ PubMed ] 10646654 Yamamoto T, Fukuyama J, Fujiyoshi A. Increased Factor VIII activity is noted 30 minutes after intranasal administration, with peak activity occurring in 90 minutes to 2 hours. 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. 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. 1. 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. Scand J Urol Nephrol Suppl. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Copyright 1993-2021 KEEP REFRIGERATED AT 2 to 8C (36 to 46F). Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude the presence of factor VIII autoantibodies. A woman who took both desmopressin and ibuprofen was found in a comatose state. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. The effect of DDAVP was measured on F VIII/vWF complex and on plasminogen activator release. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Prednisolone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin is present in small amounts in human milk and is poorly absorbed by an infant. Determine need for repeat dosage based on laboratory response and patient's clinical condition. What is the difference in Nocdurna dosage between men and women. A woman who took both desmopressin and ibuprofen was found in a comatose state. Trauma Surg Acute Care Open. Following an intranasal dose of 1.66 mcg of desmopressin for nocturia, the median apparent terminal half-life was 2.8 hours; the half-life range in patients with an eGFR above 50 mL/minute/1.73 m2 was 1.4 to 3.8 hours. Ferring Statement on Minirin / Octostim / DDAVP / Stimate Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Use combination with caution, and monitor patients for signs and symptoms 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. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Fifteen healthy men aged 55-70 years were included in the analysis. PDF Information for Patients & Parents / Carers - North Tees and Hartlepool Amlodipine; Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. Many persons with type 2 vWD do not respond to desmopressin and require alternate treatment; however, a desmopressin trial can help confirm diagnosis and may be useful in some instances of mild bleeding in persons with type 2 vWD. It may be given in the nose, by injection into a vein, by mouth, or under the tongue. Accessibility Chlorpropamide: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including chlorpropamide. official website and that any information you provide is encrypted 2002 Jun;89(9):855-62 This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Fluticasone; Vilanterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. This site complies with the HONcode standard for trust- worthy health information: verify here. Meny Lukk national monument bank uk; will arnett brothers and sisters Prolonged experience with desmopressin in pregnant women over several decades, based on the available published literature and case reports, have not identified a drug associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. -, Br J Urol. Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The usual dosage range in adults is 0.5 mL (2 mcg) to 1 mL (4 mcg) daily, administered intravenously or subcutaneously, usually in two divided doses. PDF Intravenous Medication Guidelines for Adults - VCHCA Desmopressin is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min). 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 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. 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. Carbetapentane; 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. However, individualized dosing is recommended due to high inter-patient variability in response. [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. Medication therapies A nurse cares for a client receiving vancomycin IV therapy. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. Treatment longer than 4 to 8 weeks has not been studied. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Desmopressin is not recommended for use in persons with increased intracranial pressure or those with a history of urinary retention. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. Provide short term protection for uremic hemorrhagic tendency: 0.3 mcg/kg ivpb q8h x 2 doses (diminishing response). Caution should be used when coadministering these agents. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. SEQUENTIAL THERAPY : Refers to the act of replacing a parenteral version of a medication with its oral counterpart. Withdraw the necessary volume of DDAVP Injection from the vial and dilute by adding to the infusion bag of 0.9% Sodium Chloride Injection, USP per Table 1. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> A woman who took both desmopressin and ibuprofen was found in a comatose state.