Desmopressin is a strong V2 agonist and has no effect on V1 receptors. Acetaminophen; Dextromethorphan; 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. If used preoperatively, administer 2 hours before surgery. A pharmacokinetic and pharmacodynamic comparison of desmopressin administered as whole, chewed and crushed tablets, and as an oral solution. A woman who took both desmopressin and ibuprofen was found in a comatose state. Hvistendahl GM, Riis A, Nrgaard JP, Djurhuus JC. Unable to load your collection due to an error, Unable to load your delegates due to an error. Treatment longer than 4 to 8 weeks has not been studied. The Melt dose is then derived from tablet conversion, as . The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Nonsteroidal antiinflammatory drugs: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Use combination with caution and monitor patients for signs and symptoms of hyponatremia, which may include seizures. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Persons with conditions associated with fluid and electrolyte imbalance (i.e., cystic fibrosis, heart failure, renal disorders), habitual or psychogenic polydipsia who may drink excessive amounts of water as well as elderly or pediatric (e.g., infants, children) patients and those receiving concomitant drugs that also cause hyponatremia may be at increased risk of hyponatremia. Adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. Brompheniramine; 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. 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. CAREFULLY BEFORE ACCESSING OR USING THIS SITE. 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. administration route. Avoid spraying in the eyes. Desmopressin: Corticosteroids (Systemic) may enhance the hyponatremic . If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. .2/ZfG[:{oH}ZJUmniOF F.\6K"abU:hiVyz6gAKt_|pgrqx9MUWz,_LgMvU ?>MJx 'A7 gk\nd^=zff3plgZn7GL:nnL0R2 \mSKu-08W}yx8m}R,Q3}Mm1&p#!EoA2hF"H kn.u,yQg If used preoperatively, administer 30 minutes before surgery. This site complies with the HONcode standard for trust- worthy health information: verify here. Corticosteroids: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Ketorolac (Toradol) 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. Caution should be used when coadministering these agents. 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. 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. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. KEEP REFRIGERATED AT 2 to 8C (36 to 46F). Determine need for repeat dosage based on laboratory response and patient's clinical condition. Objective: endobj 50 kg or less: 150 mcg Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Adjust treatment according to the diurnal pattern of response. Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. Vincristine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. They should also avoid drinks containing caffeine and alcohol before bedtime. SEQUENTIAL THERAPY : Refers to the act of replacing a parenteral version of a medication with its oral counterpart. MeSH 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. A desmopressin response requires an increase of at least 2 times the baseline von Willebrand factor (vWF) activity and an increase of both vWF and factor VIII concentrations of more than 0.5 International Units/mL for at least 4 hours. . Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). The antidiuretic effects of the drug last for about 5 to 21 hours, followed by an abrupt cessation of activity that occurs over a 60- to 90-minute period. 150 mcg into each nostril once for a total dose of 300 mcg. Rotoli BM, Visigalli R, Ferrari F, Ranieri M, Tamma G, Dall'Asta V, Barilli A. Biomolecules. At two hours after . Careful fluid intake restrictions are required in pediatric patients to prevent hyponatremia and water intoxication. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Valsartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 2023 Feb 10;21:eRC0124. 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. administer single spray (150 mcg) if patient >12 years of age but <50 kg body weight. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. Persons with vWD type 1 and von Willebrand factor (vWF) concentrations less than 0.3 International Units/mL or factor VIII activity equal to or less than 5% of normal may not respond to desmopressin. Ther Drug Monit. 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. An official website of the United States government. IV: 0.3 mcg/kg once slowly over 15-30 minutes. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Other evaluations have indicated that the terminal half-life for desmopressin is approximately 3 hours. Careers. It is postulated that desmopressin-induced increases in FVIII and vWF are mediated through low-affinity, extrarenal V2 receptors. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. . Desmopressin was administered orally (0.2 mg) and intravenously (2 microg), daytime and night-time, yielding four in-hospital sessions, separated by at least 2 days. Tilt bottle so that the tube inside the bottle draws from the deepest portion of the medication.To avoid the spread of infection, do not use the container for more than 1 person.For 5 mL bottles, discard after 50 sprays (doses), and for 2.5 mL bottles, discard after 25 sprays (doses) because the amount delivered thereafter per spray may be substantially less than the recommended dose. This is probably due to saturation of receptor sites. Blood pressure and heart rate monitoring during infusion is recommended. A woman who took both desmopressin and ibuprofen was found in a comatose state. Adjust doses based on patient's diurnal pattern of response. Carbetapentane; Diphenhydramine; 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. -, Br J Urol. 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. 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 . Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Provide short term protection for uremic hemorrhagic tendency: 0.3 mcg/kg ivpb q8h x 2 doses (diminishing response). doi: 10.1136/tsaco-2021-000852. Ensure that serum sodium is normal prior to initiating or resuming treatment with DDAVP Injection. Children more than 12 years of age: DDAVP Nasal SprayDDAVP nasal spray delivers doses in 0.1 mL (10 mcg) increments. The recommended maintenance dose is 5 mcg/day to 30 mcg/day (0.05 mL/day to 0.3 mL/day) intranasally in single or divided doses. 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. Pharmacokinetics and pharmacodynamics in clinical use of scopolamine. DDAVP (2 micrograms IV q8hr) is started immediately and continued until the sodium is close to normal. -. Olmesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. CrCl 50 mL/minute or more: No dosage adjustment is needed.CrCl less than 50 mL/minute OR eGFR less than 50 mL/minute/1.73 m2: Use is contraindicated. It is chemically defined as follows: Mol. Budesonide; Glycopyrrolate; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. [42295], 2 to 4 mcg IV or subcutaneously given in 1 or 2 divided doses daily. Rapid IV bolus For a patient requiring volume resuscitation, a large volume of normal saline could be . Dextromethorphan; 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. For the treatment of hypothyroidism of any etiology, except during the recovery phase of subacute thyroiditis; used as a replacement in primary (thyroidal), secondary (pituitary), tertiary (hypothalamic), congenital (cretinism), or acquired hypothyroidism. Carbetapentane; Phenylephrine; Pyrilamine: (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. SOLU CORTEF IV TO PO CONVERSION - CHRISTIANTUTTL2'S BLOG. The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. Acetaminophen; Chlorpheniramine; 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Geriatric patients 65 years of age and older treated with desmopressin for nocturia had a higher incidence of hyponatremia compared to patients less than 65 years old; therefore, monitor serum sodium more frequently in these patients. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. 1 to 2 mcg IV every 6 to 8 hours in combination with hypertonic saline. According to the Beers Criteria, desmopressin is considered a potentially inappropriate medication (PIM) in geriatric adults and avoidance is recommended for treating nocturia or nocturnal polyuria because there is a high risk of hyponatremia and safer alternatives are available. WARNINGS When Desmopressin Acetate Injection is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular in pediatric and geriatric patients, fluid intake should be adjusted downward to decrease the potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain).