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desmopressin (injection)

Pronunciation

Generic Name: desmopressin (injection) (DEZ mo press in)
Brand Name: DDAVP

What is desmopressin?

Desmopressin is a man-made form of a hormone that occurs naturally in the pituitary gland. This hormone is important for many functions including blood flow, blood pressure, kidney function, and regulating how the body uses water.

Desmopressin injection is used to treat bleeding episodes in people with hemophilia A or von Willebrand's disease Type I.

Desmopressin injection is also used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma.

Desmopressin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about injectable desmopressin?

You should not use this medication if you have severe kidney disease or if you have ever had hyponatremia (low sodium levels in your body).

You may not be able to use desmopressin if you have uncontrolled high blood pressure, severe heart failure, severe kidney disease, a condition called SIADH (syndrome of inappropriate antidiuretic hormone secretion), or any condition that causes excessive thirst, dehydration, or an electrolyte imbalance.

Call your doctor right away if you have signs of low sodium: headache, confusion, muscle cramps, severe weakness, vomiting, loss of coordination, and feeling restless or unsteady.

Limit your intake of water and other fluids while you are using desmopressin. Drinking too much water can cause your body to lose sodium, which may lead to a serious, life-threatening electrolyte imbalance.

What should I discuss with my healthcare provider before using injectable desmopressin?

You should not use this medicine if you are allergic to desmopressin, or if you have:

  • severe kidney disease; or

  • if you have ever had hyponatremia (low sodium levels in your body).

To make sure desmopressin is safe for you, tell your doctor if you have:

  • an electrolyte imbalance;

  • a psychologic disorder that causes extreme or unusual thirst;

  • fluid retention;

  • congestive heart failure, coronary artery disease;

  • high or low blood pressure;

  • urination problems;

  • kidney disease;

  • cystic fibrosis;

  • a head injury or brain tumor; or

  • a history of blood clots, stroke, or heart attack.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether desmopressin passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

How is injectable desmopressin given?

Your doctor may perform blood tests to make sure you do not have conditions that would prevent you from safely using desmopressin.

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Desmopressin is injected under the skin, or into a vein through an IV. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of needles, IV tubing, and other items used.

Desmopressin is also available as a nasal spray. If you were switched from desmopressin nasal to desmopressin injection, your dosage needs will change. The desmopressin injection dose is much lower than the desmopressin nasal dose. Follow your doctor's dosing instructions very carefully.

While using desmopressin, your blood pressure will need to be checked often and you may need frequent blood tests.

Limit your intake of water and other fluids while you are using desmopressin. Drinking too much water can cause your body to lose sodium, which may lead to a serious, life-threatening electrolyte imbalance.

Fluid restriction is especially important in children and older adults using desmopressin. Follow your doctor's instructions about the type and amount of liquids you should drink.

Prepare your dose only when you are ready to give an injection. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

If you are treating hemophilia or von Willebrand's disease, get medical attention if your bleeding is not controlled during treatment with desmopressin.

Store this medicine in the refrigerator. Do not freeze.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include headache, confusion, drowsiness, rapid weight gain, or urination problems.

What should I avoid while using desmopressin?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Desmopressin side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • low levels of sodium in the body--headache, confusion, hallucinations, muscle cramps, severe weakness, vomiting, loss of coordination, feeling restless or unsteady;

  • a seizure (convulsions);

  • weak or shallow breathing; or

  • a light-headed feeling, like you might pass out.

Common side effects may include:

  • pain, redness, burning, or swelling where the medicine was injected;

  • flushing (warmth, redness, or tingly feeling);

  • headache; or

  • nausea, stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Desmopressin dosing information

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.
The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover.

Usual Adult Dose for Hemophilia A:

IV: 0.3 mcg/kg once slowly over 15-30 minutes. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. Blood pressure and heart rate monitoring during infusion is recommended. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient.
Intranasal: 1 spray (1.5 mg/mL) in each nostril one time.
Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient.

Usual Adult Dose for von Willebrand's Disease:

IV: 0.3 mcg/kg once slowly over 15-30 minutes. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. Blood pressure and heart rate monitoring during infusion is recommended. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient.
Intranasal: 1 spray (1.5 mg/mL) in each nostril one time.
Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced.

Usual Adult Dose for Primary Nocturnal Enuresis:

Oral: 0.2 to 0.6 mg once before bedtime.

Usual Pediatric Dose for Diabetes Insipidus:

Infants 3 months of age to children 12 years of age:
Intranasal: 5 mcg/day as a single dose or in 2 divided doses. Dose range is 5 to 30 mcg/day. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover.
Oral: 0.05 mg twice a day. Dose range is 0.1 to 0.8 mg daily.
IV and subcutaneously: No definitive dosing available. Adult dosing should not be used in this age group; adverse events such as hyponatremia-induced seizures may occur. Dose should be reduced. Some have suggested an initial dosage range of 0.1 to 1 mcg in 1 or 2 divided doses. Initiate at low dose and increase as necessary. Closely monitor serum sodium levels and urine output; fluid restriction is recommended.

Children more than 12 years of age:
Intranasal: 5 to 40 mcg/day divided into 1 to 3 doses. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover.
Oral: 0.05 mg twice daily. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses.
IV: 1 to 2 mcg twice a day
Subcutaneously: 1 to 2 mcg twice a day

Use in children requires careful fluid intake restrictions to prevent possible hyponatremia and water intoxication. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover).

Usual Pediatric Dose for Hemophilia A:

Infants 3 months of age and children:
IV: 0.3 mcg/kg by slow infusion over 15-30 minutes beginning 30 minutes before procedure. May repeat dose if needed.

Children more than 12 years of age:
IV: 0.3 mcg/kg once slowly over 15-30 minutes.
Intranasal:
50 kg or less: 150 mcg
more than 50 kg: 150 mcg in each nostril.
Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient.

Usual Pediatric Dose for von Willebrand's Disease:

Infants 3 months of age and children:
IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. May repeat dose if needed.

Children more than 12 years of age:
IV: 0.3 mcg/kg once slowly over 15 to 30 minutes.
Intranasal:
50 kg or less: 150 mcg
More than 50 kg: 150 mcg in each nostril.
Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response and clinical condition of the patient. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced.

Usual Pediatric Dose for Primary Nocturnal Enuresis:

6 years or older:
0.2 to 0.6 mg orally once daily before bedtime.

What other drugs will affect desmopressin?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • an antidepressant;

  • a diuretic or "water pill";

  • narcotic pain medicine;

  • seizure medicine--carbamazepine, lamotrigine; or

  • NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with desmopressin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about desmopressin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01.

Date modified: May 03, 2017
Last reviewed: April 16, 2017

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