Desmopressin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Cranial diabetes insipidus Initial: 100 mcg tid. Maintenance: 100-200 mcg tid up to 100-1,200 mcg/day. Primary nocturnal enuresis Initial: 200 mcg at bedtime, may titrate up to 600 mcg. Sublingual Cranial diabetes insipidus Initial: 60 mcg tid. Maintenance: 60-120 mcg tid up to 720 mcg/day. IV Type I Von Willebrand's disease 0.4 mcg/kg by slow infusion over 15-30 min before surgery. Further dose may be given at 12-hrly interval. Testing of fibrinolytic response 0.4 mcg/kg infusion over 20 min. IM/SC Diagnosis of diabetes insipidus; Renal function testing 2 mcg. Headache following lumbar puncture 4 mcg, may be repeated after 24 hr if needed. May also be given as a prophylaxis. IV/IM/SC Cranial diabetes insipidus 1-4 mcg once daily. Nasal Cranial diabetes insipidus 10-20 mcg once daily or bid. Diagnosis of diabetes insipidus 20 mcg as a single dose. Renal function testing 40 mcg as a single dose. Type I Von Willebrand's disease 300 mcg; <50 kg: 150 mcg. Should be given 0.5-2 hr before surgery. Nocturia associated w/ multiple sclerosis 10-20 mcg at bedtime.
Dosage Details
Intramuscular, Subcutaneous
Diagnosis of diabetes insipidus
Adult: 2 mcg via IM or SC inj.
Child: Same as adult dose.

Intramuscular, Intravenous, Subcutaneous
Cranial diabetes insipidus
Adult: 1-4 mcg once daily via IV, IM or SC inj.
Child: 0.4 mcg daily via IV, IM, SC inj.

Intramuscular, Subcutaneous
Renal function testing
Adult: 2 mcg via IM or SC inj.
Child: Same as adult dose.

Intramuscular, Subcutaneous
Headache following lumbar puncture
Adult: 4 mcg via IM or SC inj, may be repeated after 24 hr if needed. May also be given as prophylaxis.

Intravenous
Testing of fibrinolytic response
Adult: 0.4 mcg/kg infusion over 20 min.
Child: Same as adult dose.

Intravenous
Type I Von Willebrand's disease
Adult: 0.4 mcg/kg by slow infusion over 15-30 min before surgery. Further dose may be given at 12-hr interval.
Child: Same as adult dose.

Nasal
Type I Von Willebrand's disease
Adult: 300 mcg; <50 kg: 150 mcg. Should be given 0.5-2 hr before surgery.

Nasal
Diagnosis of diabetes insipidus
Adult: 20 mcg as a single dose.
Child: Same as adult dose.

Nasal
Renal function testing
Adult: 40 mcg as a single dose.
Child: ≤1 yr 10 mcg; >1-15 yr 20 mcg. Both given as a single dose.

Nasal
Nocturia associated with multiple sclerosis
Adult: 10-20 mcg at bedtime.

Nasal
Cranial diabetes insipidus
Adult: 10-20 mcg once daily or bid.
Child: 5-20 mcg daily. Infants may require lower dose.

Oral
Cranial diabetes insipidus
Adult: Initially, 100 mcg tid, adjust according to response. Maintenance: 100-200 mcg tid up to 100-1,200 mcg daily.
Child: Same as adult dose.

Oral
Primary nocturnal enuresis
Adult: Initially, 200 mcg at bedtime, may titrate up to 600 mcg to achieve desired response.
Child: ≥6 yr Initially, 200 mcg at bedtime, may titrate up to 600 mcg to achieve desired response.

Sublingual
Cranial diabetes insipidus
Adult: Initially, 60 mcg tid. Maintenance: 60-120 mcg tid up to 720 mcg daily.
Child: Same as adult dose.
Administration
May be taken with or without food.
Reconstitution
IV infusion: Dilute in 10 mL or 50 mL of NaCl 0.9% inj.
Contraindications
Cardiac insufficiency w/ ongoing diuretic treatment. Patient w/ habitual and psychogenic polydipsia, hyponatraemia or history of hyponatraemia. Moderate to severe renal impairment (CrCl <50 mL/min).
Special Precautions
Patient w/ CV disease or cystic fibrosis, coronary artery insufficiency, at risk for increased intracranial pressure, predisposed to thrombus formation. Elderly and childn. Pregnancy and lactation.
Adverse Reactions
Headache, nausea, stomach pain, allergic skin reaction and more severe general allergic reactions, cerebral or coronary thrombosis. Local irritation, congestion and epistaxis. Pain and swelling at the inj site.
Potentially Fatal: Anaphylaxis.
IM/IV/Nasal/Parenteral/PO/SC: B
MonitoringParameters
Monitor BP and pulse during IV infusion.
Overdosage
Symptoms: Prolonged duration of action w/ an increased risk of water retention and/or hyponatraemia. Management: Symptomatic treatment. Fluid restriction.
Drug Interactions
May enhance antidiuretic effect w/ NSAIDs (e.g. ibuprofen), indometacin, TCAs, chlorpromazine, carbamazepine, SSRIs, opiates, lamotrigine. May reduce antidiuretic effect w/ lithium, epinephrine (large dose), heparin, demeclocycline.
Food Interaction
May reduce antidiuretic effect w/ alcohol.
Action
Description: Desmopressin increases cyclic adenosine monophosphate (cAMP) in renal tubular cells which increases water permeability resulting in reduced urine volume and enhanced urine osmolality. It also stimulates factor VII and plasminogen activator activity in the blood, but w/ minimal pressor activity.
Onset: Antidiuretic: Approx 60 min (oral); 15-30 min (intranasal).
Duration: Approx 6-14 hr.
Pharmacokinetics:
Absorption: Absorbed minimally from the GI tract; absorbed from the nasal mucosa. Bioavailability: 0.08-0.16% (oral); 10-20% (intranasal). Time to peak plasma concentration: 0.9 hr (oral); 1.5 hr (intranasal).
Excretion: Mainly via urine. Elimination half-life: 2-4 hr.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store between 20-25°C. Soln for inj: Store between 2-8°C. Protect from light.
MIMS Class
ATC Classification
H01BA02 - desmopressin ; Belongs to the class of vasopressin and analogues. Used in posterior pituitary lobe hormone preparations.
Disclaimer: This information is independently developed by MIMS based on Desmopressin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Minirin (dDAVP)
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in