Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. PMC Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Use this combination with caution, and monitor patients for signs and symptoms of hyponatremia. %PDF-1.5 Benazepril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Oral bioavailability: the amount of drug that enters systemic circulation when that drug is consumed orally. Dose should be reduced. 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. 1. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient. A woman who took both desmopressin and ibuprofen was found in a comatose state. 2005 Apr;95(6):804-9. doi: 10.1111/j.1464-410X.2005.05405.x. 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. If 30 mcg is divided, typically 20 mcg is given in the morning, and 10 mcg is given at night. Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or enteral nutrition and/or receiving oral medications Infection does not require IV antibiotics Afebrile (< 100.4F in the last 24 hours) Received 24 hours of IV antibiotics Prolonged experience with desmopressin in pregnant women over several decades, based on the available published literature and case reports, have not identified a drug associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. 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. Triamterene; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. Desmopressin. Dosage: (For neonatal dosages, refer to Neonatal IV Drug Manual.) If used preoperatively, administer 30 minutes before surgery. Infants 3 months of age and children: Budesonide; Glycopyrrolate; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 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. If the patient was previously receiving desmopressin tablets, dose titration is required because intranasal desmopressin is approximately 10 to 40 fold more potent than oral (tablet) desmopressin. Although the manufacturer states that nasal congestion does not affect the absorption of intranasal desmopressin, some clinicians recommend a higher dose. 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. Initiate at low dose and increase as necessary. Response should be estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Generic:- Closed containers will maintain stability for 3 weeks at controlled room temperature (68 to 77 degrees F)- Refrigerate (between 36 and 46 degrees F)DDAVP:- Discard product if it contains particulate matter, is cloudy, or discolored- Store in refrigerator at 2 to 8 degrees C (36 to 46 degrees F)Minirin:- Store at 77 degrees F; excursions permitted to 59-86 degrees F- Store uprightNocdurna:- Product should always be stored in the blister and only removed immediately before use- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in the original carton to protect from lightNoctiva:- Product must be used within 60 days after removal from refrigeration to room temperature (77 degrees F)- Store in refrigerator (36 to 46 degrees F), excursions permitted between 32 to 59 degrees F- Store uprightStimate:- Store at room temperature (up to 77 degrees F)- Store upright. 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. 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. WBC count of 3,000mm 3. IV: 0.3 mcg/kg once slowly over 15 to 30 minutes. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Dexamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ketorolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin nasal sprays may not be substituted for each other due to significant differences in concentration. 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. Determine need for repeat dosage based on laboratory response and patient's clinical condition. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Interrupt therapy for acute illness (e.g., systemic infection, fever, recurrent vomiting or diarrhea), extremely hot weather, vigorous exercise, or other conditions associated with increased water intake. Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task. The initial response is reproducible if desmopressin is given every 2 to 3 days. government site. [61810], 2 to 4 mcg IV or subcutaneously given in 1 to 2 divided doses daily. Piroxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. For patients who have been controlled on intranasal desmopressin acetate and who must be switched to the injection form, either because of poor intranasal absorption or because of the need for surgery, the comparable antidiuretic dose of the injection is about one-tenth the intranasal dose. Medication guideline for the management of neonates requiring desmopressin acetate. Missed Dose The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Famotidine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. 8600 Rockville Pike DB00035. A woman who took both desmopressin and ibuprofen was found in a comatose state. Plasminogen activator activity increases after intravenous desmopressin, but clinically significant fibrinolysis has not been detected in patients treated with desmopressin. Deflazacort: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 3 months and older: Dependent on route of administration and indication for therapy.Less than 3 months: Safety and efficacy have not been established. endobj Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The use of desmopressin for nocturia is not recommended in pregnant women; nocturia is usually related to normal, physiologic changes during pregnancy that do not require treatment with desmopressin. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Esomeprazole: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. [61810], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Dosage form: injection Drug class: Antidiuretic hormones Medically reviewed by Drugs.com. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Desmopressin systemic 0.1 mg (232 0.1 barr). Desmopressin is also used to control bed-wetting. 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. Beclomethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. 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. Methods: The study had an open, randomised, four-way cross-over design. Pharmacokinetics and pharmacodynamics in clinical use of scopolamine. His endocranologist only wants him to use it one time a day, but the problem is he goes to the bathroom sometimes every 15 minutes!!! May repeat dose after 8 to 12 hours and once daily thereafter as needed to reduce spontaneous or traumatic bleeding. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Caution should be used when coadministering these agents. . Einstein (Sao Paulo). Individualize dosing to prevent an excessive decrease in plasma osmolality, which can lead to hyponatremia and possible seizures. Increased Factor VIII activity is noted 30 minutes after IV administration, with peak activity occurring in 90 minutes to 2 hours. Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral desmopressin). Reassess patient after the initial 24 hours; if clinical status has improved may begin gradually tapering the dose. Background. Use careful attention to fluid management to avoid hyponatremia in the peripartum and postpartum period and weigh the possible therapeutic advantages against the possible risks in each individual case. Bethesda, MD 20894, Web Policies Brompheniramine; Carbetapentane; 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. Ketorolac (Toradol) Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). In hemophilia A and von Willebrand disease, it should only be used for mild to moderate cases. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. 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. Caution should be used when coadministering these agents. Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin is in a class of medications called hormones. Cisplatin can cause hyponatremia, which may increase the risk of water intoxication in patients receiving treatment with desmopressin. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. A pharmacokinetic and pharmacodynamic comparison of desmopressin administered as whole, chewed and crushed tablets, and as an oral solution. 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. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil. Desmopressin Stimulates Nitric Oxide Production in Human Lung Microvascular Endothelial Cells. MeSH 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. 1 After the original clinical study performed in Italy, desmopressin was used in 50 kg or less: 150 mcg <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> Twist off the seal from the dropper. 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. Available for Android and iOS devices. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Clipboard, Search History, and several other advanced features are temporarily unavailable. After a 300 mcg intranasal dose of desmopressin levels of Factor VIII and vWF remain greater than 30 units/dL for 8 hours. 4 0 obj Fluid restrictions should be observed. A systematic review of 30 studies of desmopressin for the treatment and prophylaxis of bleeding disorders in pregnancy (n = 216) concluded that the drug is effective in reducing bleeding complications associated with pregnancy and childbirth with a good safety record. Generic Name. Desmopressin: Corticosteroids (Systemic) may enhance the hyponatremic . 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. If used preoperatively, administer 2 hours before surgery. A woman who took both desmopressin and ibuprofen was found in a comatose state. The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. Repeat administration should be determined by laboratory response and clinical condition of the patient. Baseline renal function should be assessed. 1990 Aug;66(2):175-6 If used preoperatively, administer 2 hours before surgery. Before Methods: Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. For desmopressin Desmopressin is an analogue of vasopressin. Initial dose: 0.05 mg orally twice a day or Propranolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. More than 50 kg: 150 mcg in each nostril. Children more than 12 years of age: Desmopressin is administered intravenously or subcutaneously.Desmopressin (DDAVP) injection has an antidiuretic hormone activity of 16 International Units/mL; 1 mcg desmopressin is equivalent to 4 International Units antidiuretic hormone activity.If given preoperatively, desmopressin injection should be given 30 minutes before the scheduled procedure.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. The administration of carbamazepine prior to administration of desmopressin may act to reduce the duration of action of desmopressin. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. 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 PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The pharmacokinetics of 400 microg of oral desmopressin in elderly patients with nocturia, and the correlation between the absorption of desmopressin and clinical effect. Children more than 12 years of age: Furosemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. The peak cerebrospinal fluid concentrations are 60% greater with IV administration than with PO and 87% greater with IV administration than with PR. Initially, 10 mcg (0.1 mL) intranasally into 1 nostril, may increase to 40 mcg until the patient can sleep for an adequate period of time without incidence of polyuria. Drug class: Antidiuretic hormones. Oral to IV Conversion: The intravenous dose of levothyroxine is not the same as the oral dose. Prepare the solution for infusion using aseptic technique. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Conversion from IV to PO may reduce the need for IV access, which carries a higher risk of hospital-acquired bloodstream infections, 4 phlebitis, cellulitis, and severe adverse events associated with infiltration5 for the patient. The https:// ensures that you are connecting to the If doses other than these are required, parenteral desmopressin injection must be used.One spray (150 mcg) has an antidiuretic activity of about 600 International Units.The nasal spray must be primed prior to first use. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. Intranasal desmopressin has an antidiuretic effect of about one-tenth that of an equivalent dose administered by injection. 1997;183:53-4. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia, which may include monitoring serum sodium or electrolytes periodically. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. If patients are receiving intranasal therapy, begin oral therapy 12 hours after last intranasal dose. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. Inject subcutaneously taking care not to inject intradermally. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. After at least 7 days of treatment, the dose may be increased to 1.66 mcg, if needed, provided the serum sodium is within the normal range during treatment with the 0.83 mcg dose. The time to reach maximum plasma desmopressin levels is 0.9 hours. 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. DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Caution should be used when coadministering these agents. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. Adults and children 12 years of age and older0.5 to 1 milliliter (mL), divided into 2 doses and injected under the skin in the morning and evening. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. For All Patients Receiving Repeated Doses: Restrict free water intake and monitor for hyponatremia. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. Prilocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses. Desmopressin has also been used in congenital or acquired bleeding disorders, including drug-induced platelet dysfunction (e.g., aspirin, dextran, ticlopidine, and heparin). Usual dilution: 0.1 mcg/mL. Noctiva Nasal SprayNoctiva nasal spray delivers either 0.83 mcg or 1.66 mcg of desmopressin acetate (equivalent to 0.75 mcg or 1.5 mcg of desmopressin) per spray (0.1 mL).Two sprays of the 0.83 mcg nasal spray are not interchangeable with 1 spray of the 1.66 mcg nasal spray; the 1.66 mcg/0.1 mL nasal spray should be prescribed for patients who are or will be taking the 1.66 mcg dose.Do NOT shake the bottle.Prime the nasal spray before using for the first time by pumping 5 actuations into the air away from the face. Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. 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.
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