BJU Int. Amiloride; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Fluid intake restrictions in these patients are recommended. 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 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. Antidiuretic effects usually occur within 15 to 60 minutes, with peak effects evident 1 to 5 hours after nasal administration. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. 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. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. 1990 Aug;66(2):175-6 PDF DDAVP Injection desmopressin acetate - Food and Drug Administration A woman who took both desmopressin and ibuprofen was found in a comatose state. The necessity for repeat administration of desmopressin acetate or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. Severe allergic reactions, including anaphylaxis, have been reported with intravenous and intranasal desmopressin. Prepare the solution for infusion using aseptic technique. In a male subject with mild Von Willebrand (vW) disease, intravenous infusion of DDAVP 2 hours after administration of oral tolvaptan did not produce the expected increases in vW Factor Antigen or Factor VIII activity. 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. Every 3 months, Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. A woman who took both desmopressin and ibuprofen was found in a comatose state. I would recommend making an appointment with your regular doctor to see what might be causing this. Dose should be reduced. Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication.[42295]. If used to reduce spontaneous or traumatic bleeding, doses may be repeated after 8 hours to 12 hours and once daily thereafter, if needed, based upon clinical condition and von Willebrand factor and factor VIII levels. In general, most reported clinical experience with desmopressin has not identified efficacy response differences between geriatric and younger patients. PDF Intravenous to Oral Therapy Conversion - FormWeb Ddavp, Nocdurna, Octostim. Desmopressin is in a class of medications called hormones. 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. Repeat administration should be determined by laboratory response and clinical condition of the patient. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. The risk of toxic reactions (including water intoxication and low sodium concentrations) appears to be greater in the geriatric patient and other patients with impaired renal function. Caution should be used when coadministering these agents. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. It is not known if the drug is metabolized; however, in contrast to vasopressin, desmopressin does not appear to be degraded by the peptidase enzymes responsible for metabolizing endogenous vasopressin during the last trimester of pregnancy. The peak cerebrospinal fluid concentrations are 60% greater with IV administration than with PO and 87% greater with IV administration than with PR. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Oxybutynin: (Major) Hyponatremia-induced convulsions have been rarely reported when oxybutynin and desmopressin are used concomitantly. Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. Available for Android and iOS devices. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Use desmopressin nasal spray for nocturia with caution and monitoring of blood volume status in persons with New York Heart Association Class I congestive heart failure. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Olmesartan; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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). Dosage form: injection 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. DDAVP (Desmopressin Acetate Tablets) may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. [61810], 2 to 4 mcg IV or subcutaneously given in 1 to 2 divided doses daily. Desmopressin is a strong V2 agonist and has no effect on V1 receptors. Oral doses of 0.2 and 0.4 mg produce similar responses on urine volume and urine osmolality as 0.01 mg and 0.02 mg intranasal doses. Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task. Only start or resume therapy in patients with a normal serum sodium concentration. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fludrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin acetate 200 microgram tablets; 10microgram/mL WCHN Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude severe von Willebrand's disease (Type I) and presence of abnormal molecular form of factor VIII antigen. Thiazide diuretics: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. When desmopressin is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular pediatric and geriatric patients, fluid intake should be adjusted downward to decrease to potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain). Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Less vasopressor activity. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. IN 1977 DESMOPRESSIN (1-deamino-8-D-arginine vasopressin, abbreviated DDAVP), a derivative of the antidiuretic hormone, was used for the first time to treat patients with hemophilia A and von Willebrand disease (vWD), the most frequent congenital bleeding disorders. Tricyclic antidepressants: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including tricyclic antidepressants. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 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. Desmopressin is contraindicated in patients with moderate to severe renal impairment (e.g., CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2). Losartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. The .gov means its official. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. Acetaminophen; Chlorpheniramine; 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. 2 mg PO - 15 mg IV. Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. 1996 Sep;42(3):379-85 Fluid restrictions should be observed. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. PDF Converting oral to intravenous or subcutaneous infusions - APPM IV: 0.3 mcg/kg by slow infusion over 15-30 minutes beginning 30 minutes before procedure. Oral: 0.05 mg twice a day. Desmopressin - FPnotebook.com Monitor serum sodium concentrations within 1 week and then approximately 1 month after treatment initiation and periodically thereafter. 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. 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 pharmacokinetic profile of desmopressin is biexponential. The pump will stay primed for up to 1 week. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Bioavailability and pharmacokinetics of desmopressin in elderly men. A woman who took both desmopressin and ibuprofen was found in a comatose state. Vasopressin, ADH: (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 vasopressin, ADH only with careful patient monitoring. Desmopressin is contraindicated in persons with hyponatremia or a history of hyponatremia, polydipsia, concomitant loop diuretic or systemic or inhaled corticosteroid therapy, known or suspected syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and other illnesses that can cause fluid and electrolyte imbalance, such as gastroenteritis, salt-wasting nephropathies, or systemic infection. A woman who took both desmopressin and ibuprofen was found in a comatose state. PLEASE READ THE. Levels of FVIII are also increased, which increases hemostasis by accelerating fibrin formation. Idiopathic partial central diabetes insipidus. -, Br J Clin Pharmacol. IV Push for Hyperkalemia. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. Desmopressin: Uses, Interactions, Mechanism of Action - DrugBank Med Surg ATI Proctored Exam Test Bank A 1 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 bleeding, desmopressin increases the blood levels of factor VIII and von Willebrand . 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. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Dexamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Prilocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. For desmopressin Desmopressin is an analogue of vasopressin. Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. Desmopressin Intranasal (Noctiva, low dose) Each spray delivers 0.83 to 1.66 mcg Marketed for Nocturia in adults (but other non-medication approaches are preferred) Expensive: $425/month in 2018 Desmopressin Oral Initial: 0.2 mg PO qhs Use lowest effective dose Increase as needed to 0.6 mg at bedtime VII. endobj
Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. As of 2007 the intranasal formulation is no longer FDA-approved for the treatment of primary nocturnal enuresis secondary to postmarketing reports of hyponatremia-related seizures, which most often occurred in children using the intranasal formulation. Dilute DDAVP Injection in sterile 0.9% Sodium Chloride Injection, USP and infuse slowly over 15 minutes to 30 minutes. Example: Ampicillin-sulbactam 1.5gm IV Q6H to amoxicillin-clavulanic acid 875mg/125mg PO Q12H. Withdraw the necessary volume of DDAVP Injection from the vial and dilute by adding to the infusion bag of 0.9% Sodium Chloride Injection, USP per Table 1. DDAVP Injection (desmopressin acetate) is a man-made form of a hormone that occurs naturally in the pituitary gland used to treat hemophilia A or von Willebrand's disease Type I, and is also used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma. 2022 Mar 2;12(3):389. doi: 10.3390/biom12030389. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. 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. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin acts similarly to native vasopressin. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Also assess serum sodium and aPTT prior to treatment. 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. Hydrocortisone (systemic): Drug information - UpToDate After a 300 mcg intranasal dose of desmopressin levels of Factor VIII and vWF remain greater than 30 units/dL for 8 hours. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Methyclothiazide: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The recommended starting dose is 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. This medication helps to control increased thirst and too much urination due to these conditions . eCollection 2023. Intranasal desmopressin 300 mcg results in maximal Factor VIII and von Willebrand Factor activity levels 150% to 250% of normal. [33605], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. Provide short term protection for uremic hemorrhagic tendency: 0.3 mcg/kg ivpb q8h x 2 doses (diminishing response). About 1/4 to 1/3 of patients can be controlled by a single daily dose. Intranasal: Controls bleeding in certain types of hemophilia and von Willebrand's disease Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. Careful fluid intake restrictions are required in pediatric patients to prevent hyponatremia and water intoxication. Vasopressin also causes constriction of vascular smooth muscle and contraction of smooth muscle in the GI tract and uterus. 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. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. Converting Po To Iv Hydrocortisone Recipes Desmopressin | Drugs | BNF | NICE Children more than 12 years of age: Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. MeSH Results: 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 iv to po conversion - finbi.no 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. 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. .2/ZfG[:{oH}ZJUmniOF F.\6K"abU:hiVyz6gAKt_|pgrqx9MUWz,_LgMvU ?>MJx
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