Drug interactions between DDAVP and Dilaudid
| Results for the following 2 drugs: |
|---|
| DDAVP (desmopressin) |
| Dilaudid (hydromorphone) |
Interactions between your selected drugs
hydromorphone ↔ desmopressin
Applies to:Dilaudid (hydromorphone) and DDAVP (desmopressin)
MONITOR: Coadministration with opiates may increase the plasma concentrations and pharmacologic effects of oral desmopressin. The risk of water intoxication and/or hyponatremia may be increased. In 18 healthy subjects, loperamide 4 mg given at 24 hours, 12 hours, and 1 hour before a single 400 mcg oral dose of desmopressin increased the peak plasma concentration (Cmax) of desmopressin by 2.3-fold and its systemic exposure (AUC) by 3.1-fold. Pretreatment with loperamide also increased the median time to reach peak desmopressin concentration (Tmax) from 1.3 to 2 hours, but did not affect the terminal elimination half-life. Although not investigated, other opiates may interact similarly with desmopressin by slowing gastrointestinal motility. In addition, some opiate analgesics such as fentanyl, meperidine, morphine, oxycodone, and tramadol have been associated with reports of hyponatremia, sometimes secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). These effects may be additive with those of desmopressin and probably stem from agonist action on morphinic receptors, resulting in increased release of antidiuretic hormone.
MANAGEMENT: Caution is recommended if desmopressin is used in combination with opiates. Serum electrolytes, especially sodium, as well as BUN and creatinine should be monitored regularly. Patients should be advised to seek immediate medical attention if they develop early signs and symptoms of water intoxication or hyponatremia such as anorexia, nausea, vomiting, drowsiness, lethargy, weakness, listlessness, headache, confusion, difficulty concentrating, memory impairment, anuria, and weight gain. Early treatment may help prevent progression to seizure, coma, respiratory arrest, and death.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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