Hemophilia A and von Willebrand's Disease (Type I): The recommended dosage is 0.3 mcg/kg actual body weight (to a maximum of 20 mcg) administered by intravenous infusion over 15 minutes to 30 minutes. R8cxz. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Lidocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. PATIENTS NOT AT INCREASED RISK FOR HYPONATREMIA: 1 spray (1.66 mcg) in either the left or right nostril approximately 30 minutes before going to bed. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin is contraindicated in persons with moderate to severe renal impairment (CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2) and renal failure. Children more than 12 years of age: During the initial titration period and continued therapy, observe and monitor closely. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). Wash the rhinal tube in water and shake well, until no water is left in the tube.To avoid the spread of infection, do not use the container for more than 1 person.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. 0.02 mg IN, 0.2 mg PO and 0.4 mg PO) have a similar, pronounced pharmacodynamic effect on urine volume and urine osmolality. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin is present in small amounts in human milk and is poorly absorbed by an infant. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. Tachyphylaxis (lessening of response) with repeated administration (i.e., given more frequently than every 48 hours) may occur. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil. Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. 1 0 obj May repeat dose if needed. Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. 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. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. <> 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. Barnabei A, Corsello A, Paragliola RM, Iannantuono GM, Falzone L, Corsello SM, Torino F. Cancers (Basel). 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 not indicated for persons with severe classic vWD (type 1), for the treatment of hemophilia B, or in persons with factor VIII antibodies. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Drugs; . THOSE AT INCREASED RISK FOR HYPONATREMIA: 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. Cyclizine SC or IV Nausea and vomiting 0.5 1 14.5 0 Diamorphine$ SC or IV Pain 0.075 0.1 2.175 2.9 1.45 3.2625 Diazepam PR Agitation, convulsions 10 Hydrocortisone IV Anaphylaxis 2 4 58 116 Hyoscine hydrobromide SC or IV Respiratory tract secretions 0.01 0.01 0.29 0.29 Midazolam SC or IV Anxiety or agitation 0.06 0.1 1.74 2.9 2 4.5 A woman who took both desmopressin and ibuprofen was found in a comatose state. 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Irbesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Idiopathic partial central diabetes insipidus. During the initial titration period and continued therapy, observe and monitor closely; treatment should be adjusted according to the diurnal pattern of response. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Fluid restrictions should be observed. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Missed Dose -The most preferred drug is desmopressin acetate (DDAVP), a synthetic form of vasopressin given orally, as a sublingual "melt," or intranasally in a metered spray. A woman who took both desmopressin and ibuprofen was found in a comatose state. Dose should be reduced. A woman who took both desmopressin and ibuprofen was found in a comatose state. The Melt dose is then derived from tablet conversion, as . DB00035. Although rare, chlorpropamide has caused a reaction identical to symptom of inappropriate antidiuretic hormone (SIADH). The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Indomethacin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diclofenac; Misoprostol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. wt. A pharmacokinetic and pharmacodynamic comparison of desmopressin administered as whole, chewed and crushed tablets, and as an oral solution. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Also known as antidiuretic hormone (ADH), vasopressin is secreted by the hypothalamus in response to hyperosmolarity, volume depletion, stress (emotional or physiological), certain drugs, and painful stimuli. Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. % Caution should be used when coadministering these agents. Intranasal: 5 to 40 mcg/day divided into 1 to 3 doses. Fluticasone; Vilanterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Flurbiprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 1998 Nov;82(5):642-6 <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Promethazine; 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. Monitor blood pressure during desmopressin administration, particularly in persons with coronary artery disease (insufficiency) and/or hypertension; desmopressin may cause hypotension (with compensatory increase in heart rate) or hypertension. The time to reach maximum plasma desmopressin levels is 0.9 hours. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. official website and that any information you provide is encrypted What is the difference in Nocdurna dosage between men and women. The pharmacokinetic profile of desmopressin is biexponential. xTMk1?DFh!PiHhmz(=lk;p"v< Fobt7t?@IFT];XaYV={~w ^JLAIIG\G\m$XJe@xH8!ZDhrN*'VH4'J.cq 'A%;v}q+i+&L 44qDxR)o3 Preserve in tight containers, protected from light. -, Br J Urol. Guidelines describe preemptive desmopressin administration to prevent sodium overcorrection. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Eprosartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Budesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Sulindac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Inject subcutaneously taking care not to inject intradermally. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. Objective: 1 to 2 mcg IV twice a day or HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. A woman who took both desmopressin and ibuprofen was found in a comatose state. Bethesda, MD 20894, Web Policies Meny Lukk national monument bank uk; will arnett brothers and sisters WBC count of 3,000mm 3. 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. Prepare the solution for infusion using aseptic technique. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. Response to vasopressin is mediated through two receptors: the V1 receptor, which mediates smooth muscle contraction in the peripheral vasculature, and the V2 receptor, which regulates water resorption in the collecting ducts. e-N;CM_[9,jPUO'@O%W]I,7wO;~ -O{GOiZb]]qJy=q4/I3>1&p#!EoA2hF"H kn.u,yQg Study results show the C max of IV acetaminophen is 76% greater than PO and 256% greater than PR. Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. IV infusion . Determine need for repeat dosage based on laboratory response and patient's clinical condition. Indications and dose Diabetes insipidus, treatment By mouth Child 1-23 months Initially 10 micrograms 2-3 times a day, adjusted according to response; usual dose 30-150 micrograms daily. [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. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. In general, desmopressin is contraindicated in persons with heart failure or uncontrolled hypertension because fluid retention increases the risk for worsening of underlying conditions that are susceptible to volume status. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Intranasal desmopressin 300 mcg results in maximal Factor VIII and von Willebrand Factor activity levels 150% to 250% of normal. Acetaminophen; 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. Intermittent intravenous infusionFor adults and children weighing greater than 10 kg, dilute dose in 50 mL of 0.9% Sodium Chloride for injection. Carbinoxamine; 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. 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. DDAVP, Minirin, Nocdurna, Stimate, +2 more. Atenolol; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. IV infusion IV Infusion IV Infusion (OB) Only REGULAR insulin may be administered by the IV route. Initially, 0.05 mg PO once daily. All Rights Reserved. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. Dose range is 5 to 30 mcg/day. Hydrochlorothiazide, HCTZ; Methyldopa: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. . The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. Repeat administration should be determined by laboratory response and clinical condition of the patient. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Lisinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. For All Patients Receiving Repeated Doses: Patients changing from intranasal desmopressin: We comply with the HONcode standard for trustworthy health information. The tendency toward tachyphylaxis (lessening of response) with repeated administration given more frequently than every 48 hours should be considered in treating each patient. Dexamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. If doses other than these are required, the rhinal tube delivery system may be used.One spray (10 mcg) has an antidiuretic activity of about 40 International Units.The nasal spray must be primed prior to first use. 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. It acts on the kidneys to reduce the flow of urine. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil. In a single study of postpartum women receiving a single dose of intranasal desmopressin, a marked change in plasma concentration of desmopressin was seen; however, little, if any, change in assayable desmopressin was found in breast milk. 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. 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 . more than 50 kg: 150 mcg in each nostril. The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. Desmopressin is not effective in persons with type 3 von Willebrand's disease (vWD) and can cause platelet aggregation, thrombocytopenia, and possibly thrombosis in persons with type 2B vWD. Fluid restrictions should be observed. [61810], 2 to 4 mcg IV or subcutaneously given in 1 to 2 divided doses daily. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. 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. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> Amlodipine; Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Greatly enhanced ADH activity. During treatment with DDAVP Injection, assess serum sodium, bleeding time, factor VIII coagulant activity, ristocetin cofactor activity, and von Willebrand antigen to ensure that adequate levels are being achieved. Do Not Copy, Distribute or otherwise Disseminate without express permission. 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. In the elderly, careful dosage selection and monitoring of renal function are recommended. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. In certain clinical situations, it may be justified to try desmopressin in persons with factor VIII concentrations of 2% to 5%; however, carefully monitor these patients. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. The mean (+/- S.D.) 4 0 obj At two hours after . IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. The frequency of dosing varies with patient responses. 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. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. Child 2-11 years Adjust for an adequate diurnal rhythm of urine output. 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. Caution should be used when coadministering these agents. A woman who took both desmopressin and ibuprofen was found in a comatose state. 1 After the original clinical study performed in Italy, desmopressin was used in Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. 1996 Sep;42(3):379-85 Carbamazepine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including carbamazepine. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Opiate Agonists: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including opiate agonists. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fenoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. DDAVP will also stop bleeding in hemophilia A patients with episodes of spontaneous or trauma-induced injuries such as hemarthroses, intramuscular hematomas or mucosal bleeding. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. -, BJU Int. The necessity for repeat administration of DDAVP or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication.[42295]. Acetaminophen; Dextromethorphan; 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. Careers. Caution should be used when coadministering these agents. Direct intravenous injectionNo dilution necessary.Inject IV over 1 minute. To prime, press down 4 times. Hougaard C, Matthiesen TB, Rittig S, Djurhuus JC. 1183.34 Fifteen healthy men aged 55-70 years were included in the analysis. The initial response is reproducible if DDAVP is administered every 2 to 3 days. 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. See Table 1 for volume of diluent to use. HHS Vulnerability Disclosure, Help Methods: The study had an open, randomised, four-way cross-over design. Q@xtt/ A woman who took both desmopressin and ibuprofen was found in a comatose state. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. 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.
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