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The plasma concentrations generally declined below 2 pg/mL (lower limit of quantitation) 4 to 6 hours post-dose. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diflunisal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Amlodipine; Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 0.2 to 0.6 mg orally once daily before bedtime. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Sumatriptan; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. IV: 0.3 mcg/kg once slowly over 15 to 30 minutes. Initiate fluid restriction during treatment with DDAVP Injection [see Warnings and Precautions (5.1), Use in Specific Populations (8.4, 8.5)]. 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. Caution should be used when coadministering these agents. Subcutaneously: 1 to 2 mcg twice a day Methylprednisolone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. For All Patients Receiving Repeated Doses: Restrict free water intake and monitor for hyponatremia. Medically reviewed by Drugs.com. As of 2007 in response to a FDA request for removal of the indication, the intranasal formulation is no longer indicated for the treatment of primary nocturnal enuresis secondary to post-marketing reports of hyponatremic-related seizures, which most often occurred in pediatric patients. IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. Infants 3 months of age and children: 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 may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. 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). 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. 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. 1 0 obj Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. In the elderly, careful fluid intake restrictions are required to prevent hyponatremia and water intoxication. A woman who took both desmopressin and ibuprofen was found in a comatose state. . Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. If used preoperatively, administer 30 minutes prior to the procedure. 4 0 obj 2 mg PO - 15 mg IV. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. If used preoperatively, administer 2 hours before surgery. Clin Endocrinol (Oxf). Tachyphylaxis (lessening of response) with repeated administration (i.e., given more frequently than every 48 hours) may occur. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. 6 years or older: I would recommend making an appointment with your regular doctor to see what might be causing this. Cisplatin: (Moderate) Frequently monitor serum sodium levels if concurrent use of desmopressin and cisplatin is necessary. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). The Melt dose is then derived from tablet conversion, as . Lansoprazole; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. This site needs JavaScript to work properly. Many persons with type 2 vWD do not respond to desmopressin and require alternate treatment; however, a desmopressin trial can help confirm diagnosis and may be useful in some instances of mild bleeding in persons with type 2 vWD. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. 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. During the initial titration period and continued therapy, observe and monitor closely. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin is in a class of medications called hormones. endobj Caution should be used when coadministering these agents. The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. Greatly enhanced ADH activity. BJU Int. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Atenolol; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Last updated on Apr 7, 2022. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. IV: 100 mg IV bolus given immediately, followed by 25 to 75 mg IV every 6 hours or 200 mg/24 hours as a continuous IV infusion for the first 24 hours. Find medical information for DDAVP on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. 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. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Trauma Surg Acute Care Open. DrugBank Accession Number. Olopatadine; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Disclaimer. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> The site is secure. Metolazone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Fosinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. On Days 1, 3 and 5, subjects were dosed intranasally with escalating doses of AV002 nasal spray. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. 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. Repeat dosing is not recommended due to tachyphylaxis. For antimicrobial interchanges: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per protocol. Adjust treatment according to the diurnal pattern of response. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days.