Desmopressin systemic 0.1 mg (232 0.1 barr). Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. Available for Android and iOS devices. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. Dose should be reduced. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses. Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Caution should be used when coadministering these agents. Main menu. Metoprolol; 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 Injection (Desmopressin Acetate Injection): Uses, Dosage - RxList Children younger than 12 years of ageUse and dose must be determined by your doctor. -, Br J Urol. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. sharing sensitive information, make sure youre on a federal 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. Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Wirtz MR, Roelofs JJ, Goslings JC, Juffermans NP. Ferring Statement on Minirin / Octostim / DDAVP / Stimate Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. stream During the initial titration period and continued therapy, observe and monitor closely; treatment should be adjusted according to the diurnal pattern of response. Monitor blood pressure and pulse during infusion. 2023 Feb 10;21:eRC0124. 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. 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. how do you switch from labetalol IV to PO. Although the manufacturer states that nasal congestion does not affect the absorption of intranasal desmopressin, some clinicians recommend a higher dose. The concentration-time curve after 2 microg intravenous desmopressin was best described using a biexponential term. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient. Indications: Hemophilia (increases factor VIII levels): 0.3 mcg/kg in 50ml normal saline over 15-30 minutes. Flurbiprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 1995 Apr;42(4):373-8. doi: 10.1111/j.1365-2265.1995.tb02645.x [ PubMed ] 10646654 Yamamoto T, Fukuyama J, Fujiyoshi A. Intranasal: Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Piroxicam: (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 distribution of the drug is unknown, and it is not clear whether desmopressin crosses the placenta. Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. When DDAVP /Desmopressin Injection is used for diagnostic purposes, fluid intake must be limited and not exceed 0.5 litres from 1 hour before until 8 hours after administration. Monitor renal function and clinical status closely during use. %PDF-1.5 Subcutaneously: 1 to 2 mcg twice a day PDF Intravenous to Oral Therapy Conversion - FormWeb In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. DDAVP, Stimate (desmopressin) dosing, indications, interactions Desmopressin is primarily excreted in the urine, with a significant portion excreted as unchanged drug (65% after oral and 92% after intranasal administration). IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral desmopressin). NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. Pretreatment Testing and On-Treatment Monitoring Diabetes Insipidus Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Desmopressin is also used to control excessive thirst and the passage of an abnormally large amount of urine that may occur after a head injury or after certain types of surgery. 55.3 mcg sublingually once daily, 1 hour before bedtime without water. If Desmopressin Acetate Injection 4 mcg/mL is used preoperatively, it should be administered 30 minutes prior to the scheduled procedure. 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. Single-dose administration has been used for uremic bleeding in patients with renal failure; however, repeat doses are not recommended. 1/10 of intranasal dose . Baseline renal function should be assessed. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Administer with a 0.22 micron filter. Find medical information for DDAVP on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. Example: Ampicillin-sulbactam 1.5gm IV Q6H to amoxicillin-clavulanic acid 875mg/125mg PO Q12H. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. Usual dilution: 0.1 mcg/mL. Clin Endocrinol (Oxf). 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. DDAVP, Minirin, Nocdurna, Stimate, +2 more. 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 . Some have suggested an initial dosage range of 0.1 to 1 mcg in 1 or 2 divided doses. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Desmopressin acetate injection is administered as an intravenous infusion at a dose of 0.3 mcg desmopressin acetate/kg body weight diluted in sterile physiological saline and infused slowly over 15 to 30 minutes. Copyright 2021 GlobalRPH - Web Development by, The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. 2022 Feb 18;14(4):1057. doi: 10.3390/cancers14041057. Deflazacort: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. endobj Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. 4 0 obj May repeat dose if needed. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. May repeat dose if needed. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. Amlodipine; Celecoxib: (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 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. Persons with renal disease may be at increased risk for low sodium concentrations, fluid overload, and electrolyte abnormalities. Selective serotonin reuptake inhibitors: (Minor) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including SSRIs. 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.
