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DDAVP Nasal Side Effects

Generic name: desmopressin

Medically reviewed by Last updated on Sep 29, 2023.

Note: This document contains side effect information about desmopressin. Some dosage forms listed on this page may not apply to the brand name DDAVP Nasal.

Applies to desmopressin: oral tablet. Other dosage forms:

Serious side effects of DDAVP Nasal

Along with its needed effects, desmopressin (the active ingredient contained in DDAVP Nasal) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking desmopressin:


Incidence not known

Other side effects of DDAVP Nasal

Some side effects of desmopressin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

For Healthcare Professionals

Applies to desmopressin: injectable solution, nasal solution, nasal spray, oral tablet, sublingual tablet.


Cardiovascular side effects have infrequently included transient and slight elevations or reductions in blood pressure, a compensatory change in heart rate, and facial flushing with injections of desmopressin (the active ingredient contained in DDAVP Nasal) (DDAVP). Vasodilation and water retention have occurred. There have been rare reports of thrombotic events (acute cerebral thrombosis, acute myocardial infarction) in some patients after DDAVP injection. At least one case of fatal left coronary thrombosis has been associated with the use of DDAVP.[Ref]

One review of the literature found that the incidence of thrombotic events associated with the use of DDAVP to reduce blood loss and transfusion requirements in surgical patients was not significantly higher than placebo. In any case, the incidence of thrombosis is rare. One review found only 10 reports of thrombosis over a 4-year period, covering 433,000 doses of DDAVP.[Ref]

Nervous system

Nervous system side effects have included seizures and/or coma as a result of severe water intoxication and hyponatremia. Other nervous system side effects have included headache and dizziness in less than 3% of patients. DDAVP nasal spray has been infrequently associated with somnolence, lethargy, paresthesias, fatigue, confusion, stupor, malaise, diaphoresis, itchy or light-sensitive eyes, insomnia, chills, warm feeling, and agitation.[Ref]

The risk factors for DDAVP-induced hyponatremia include stress, surgery, anesthesia, narcotics (endogenous release of ADH), vomiting (loss of sodium), liver disease (hindered metabolism of DDAVP), overhydration with hyponatremic fluids, and advanced age. In some cases, fluid restriction, avoidance of hyponatremic solutions, and close monitoring of serum electrolytes and urine output for at least 15 to 20 hours after the administration of DDAVP may be beneficial.[Ref]


Hematologic side effects have included platelet aggregation and thrombocytopenia. These have been seen almost uniquely in patients with von Willebrand's disease Type IIB (DDAVP is contraindicated in these patients).[Ref]


Local side effects of injections of DDAVP have included intravenous site erythema, swelling, and burning.[Ref]


Respiratory side effects of intranasal DDAVP have included rhinitis, epistaxis, and nostril pain in 2% to 10% of patients. Apnea and cardiac arrest occurred in one patient.[Ref]


Gastrointestinal side effects have included mild abdominal cramps and nausea in 2% of patients. Dyspepsia and vomiting have rarely been associated with DDAVP nasal spray.[Ref]


Hypersensitivity reactions have rarely included anaphylaxis.[Ref]


Psychiatric side effects have included a single case of paranoid psychosis associated with the use of DDAVP nasal spray.[Ref]

Frequently asked questions


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2. D'Alauro FS, Johns RA (1988) "Hypotension related to desmopressin administration following cardiopulmonary bypass." Anesthesiology, 69, p. 962-3

3. Brommer EJ, van Brummelen P, Derkx FH (1985) "Desmopressin and hypotension." Ann Intern Med, 103, p. 962

4. Harris AS (1989) "Clinical experience with desmopressin: efficacy and safety in central diabetes insipidus and other conditions." J Pediatr, 114, p. 711-8

5. McLeod BC (1990) "Myocardial infarction in a blood donor after administration of desmopressin." Lancet, 336, p. 1137-8

6. Mannucci PM, Lusher JM (1989) "Desmopressin and thrombosis." Lancet, 2, p. 675-6

7. Lowe GD (1989) "Desmopressin and myocardial infarction." Lancet, 1, p. 895-6

8. Israels SJ, Kobrinsky NL (1989) "Serious reaction to desmopressin in a child with cyanotic heart disease." N Engl J Med, 320, p. 1563-4

9. Bond L, Bevan D (1988) "Myocardial infarction in a patient with hemophilia treated with DDAVP." N Engl J Med, 318, p. 121

10. Byrnes JJ, Larcada A, Moake JL (1988) "Thrombosis following desmopressin for uremic bleeding." Am J Hematol, 28, p. 63-5

11. Pigache RM (1984) "Facial flushing induced by vasopressin-like peptides lacking pressor activity." Br J Clin Pharmacol, 17, p. 369-71

12. Miller K, Atkin B, Moody ML (1992) "Drug therapy for nocturnal enuresis. Current treatment recommendations." Drugs, 44, p. 47-56

13. Albert SG, Salvato-Lechner V, Joist JH (1988) "Venous thromboembolism and transient thrombocytopenia in a patient with diabetes insipidus treated with desmopressin acetate (DDAVP)." Thromb Res, 50, p. 695-705

14. Vigano GL, Mannucci PM, Lattuada A, Harris A, Remuzzi G (1989) "Subcutaneous desmopressin (DDAVP) shortens the bleeding time in uremia." Am J Hematol, 31, p. 32-5

15. Salva KM, Kim HC, Nahum K, Fallot PL (1988) "DDAVP in the treatment of bleeding disorders." Pharmacotherapy, 8, p. 94-9

16. Hjalmas K, Bengtsson B (1993) "Efficacy, safety, and dosing of desmopressin for nocturnal enuresis in Europe." Clin Pediatr (Phila), Spec No, p. 19-24

17. Mannucci PM, Carlsson S, Harris AS (1994) "Desmopressin, surgery and thrombosis." Thromb Haemost, 71, p. 154-5

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19. (2001) "Product Information. Stimate (desmopressin)." Forest Pharmaceuticals

20. Hartmann S, Reinhart W (1995) "Fatal complication of desmopressin." Lancet, 345, p. 1302-3

21. Vermylen J, Peerlinck K (1995) "Fatal complication of desmopressin." Lancet, 346, p. 447

22. Hartmann S (1995) "Fatal complication of desmopressin - reply." Lancet, 346, p. 447

23. Sun HL, Chien CC (1998) "Thrombocytopenia and subdural hemorrhage after desmopressin administration." Anesthesiology, 88, p. 1115-7

24. Hamed M, Mitchell H, Clow DJ (1993) "Hyponatraemic convulsion associated with desmopressin and imipramine treatment." BMJ, 306, p. 1169

25. Simmonds EJ, Mahony MJ, Little JM (1988) "Convulsion and coma after intranasal desmopressin in cystic fibrosis." BMJ, 297, p. 1614

26. Beach PS, Beach RE, Smith LR (1992) "Hyponatremic seizures in a child treated with desmopressin to control enuresis. A rational approach to fluid intake." Clin Pediatr (Phila), 31, p. 566-9

27. Shepherd LL, Hutchinson RJ, Worden EK, Koopmann CF, Coran A (1989) "Hyponatremia and seizures after intravenous administration of desmopressin acetate for surgical hemostasis." J Pediatr, 114, p. 470-2

28. Yaouyanc G, Jonville AP, Yaouyanc-Lapalle H, Barbier P, Dutertre JP, Autret E (1992) "Seizure with hyponatremia in a child prescribed desmopressin for nocturnal enuresis." J Toxicol Clin Toxicol, 30, p. 637-41

29. Weinstein RE, Bona RD, Altman AJ, Quinn JJ, Weisman SJ, Bartolomeo A, Rickles FR (1989) "Severe hyponatremia after repeated intravenous administration of desmopressin." Am J Hematol, 32, p. 258-61

30. Smith TJ, Gill JC, Ambruso DR, Hathaway WE (1989) "Hyponatremia and seizures in young children given DDAVP." Am J Hematol, 31, p. 199-202

31. Sukhai RN (1993) "Enuresis nocturna: long term use and safety aspects of minrin (desmopressin) spray." Regul Pept, 45, p. 309-10

32. Hourihane J, Salisbury AJ (1993) "Use caution in prescribing desmopressin for nocturnal enuresis." BMJ, 306, p. 1545

33. Asplund R, Aberg H (1993) "Desmopressin in elderly women with increased nocturnal diuresis. A short-term study." Br J Urol, 72, p. 42-5

34. Kallio J, Rautava P, Huupponen R, Korvenranta H (1993) "Severe hyponatremia caused by intranasal desmopressin for nocturnal enuresis." Acta Paediatr, 82, p. 881-2

35. Humphries JE, Siragy H (1993) "Significant hyponatremia following DDAVP administration in a healthy adult." Am J Hematol, 44, p. 12-5

36. Stenberg A, Lackgren G (1994) "Desmopressin tablets in the treatment of severe nocturnal enuresis in adolescents." Pediatrics, 94, p. 841-6

37. Schwab M, Wenzel D, Ruder H (1996) "Hyponatraemia and cerebral convulsion due to short term DDAVP therapy for control of enuresis nocturna." Eur J Pediatr, 155, p. 46-8

38. Williford SL, Bernstein SA (1996) "Intranasal desmopressin-induced hyponatremia." Pharmacotherapy, 16, p. 66-74

39. Robson WLM (1996) "Water intoxication in patients treated with desmopressin." Pharmacotherapy, 16, p. 969-70

40. Williford SL (1996) "Water intoxication in patients treated with desmopressin - reply." Pharmacotherapy, 16, p. 970

41. Robson WLM, Norgaard JP, Leung AKC (1996) "Hyponatremia in patients with nocturnal enuresis treated with DDAVP." Eur J Pediatr, 155, p. 959-62

42. Odeh M, Oliven A (2001) "Coma and seizures due to severe hyponatremia and water intoxication in an adult with intranasal desmopressin therapy for nocturnal enuresis." J Clin Pharmacol, 41, p. 582-4

43. Sweeney JD, Hoernig LA, Behrens AN, Novak E, Swank RT (1990) "von Willebrand's variant (type II Buffalo). Thrombocytopenia after desmopressin but absence of in vitro hypersensitivity to ristocetin." Am J Clin Pathol, 93, p. 522-5

44. Holmberg L, Nilsson IM, Borge L, Gunnarsson M, Sjorin E (1983) "Platelet aggregation induced by 1-desamino-8-D-arginine vasopressin (DDAVP) in Type IIB von Willebrand's disease." N Engl J Med, 309, p. 816-21

45. Castaman G, Rodeghiero F, Lattuada A, Mannucci PM (1993) "Desmopressin-induced thrombocytopenia in type I platelet discordant von Willebrand disease." Am J Hematol, 43, p. 5-9

46. Itabashi A, Katayama S, Yamaji T (1982) "Hypersensitivity to chlorobutanol in DDAVP solution." Lancet, 1, p. 108

47. Collins GB, Marzewski DJ, Rollins MB (1981) "Paranoid psychosis after DDAVP therapy for Alzheimer's dementia." Lancet, 2, p. 808

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.