After a 300 mcg intranasal dose of desmopressin levels of Factor VIII and vWF remain greater than 30 units/dL for 8 hours. 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. The site is secure. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. Intranasal desmopressin 300 mcg results in maximal Factor VIII and von Willebrand Factor activity levels 150% to 250% of normal. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Lithium: (Moderate) The antidiuretic response to desmopressin may be reduced in patients receiving lithium concomitantly. Applies to the following strengths: 0.15 mg/inh; 10 mcg/inh; 4 mcg/mL; 0.1 mg; 0.2 mg; 15 mcg/mL; 0.01%; 27.7 mcg; 55.3 mcg; 0.83 mcg/0.1 mL; 1.66 mcg/0.1 mL; 15 mcg/inh. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. YES.
PDF DDAVP Nasal Spray DESCRIPTION DDAVP - Food and Drug Administration The plasma concentrations generally declined below 2 pg/mL (lower limit of quantitation) 4 to 6 hours post-dose. 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. Hougaard C, Matthiesen TB, Rittig S, Djurhuus JC. Doses may be titrated up to 0.6 mg PO once daily at bedtime, depending on individual patient response. SOLU CORTEF IV TO PO CONVERSION - CHRISTIANTUTTL2'S BLOG. Bisoprolol; 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 comparison was made of intranasal administration of 300 micrograms desmopressin (DDAVP) by spray, with intravenous administration of 0.2, 0.3 and 0.4 microgram DDAVP/kg in 10 healthy volunteers. Blood pressure and pulse should be monitored during infusion. Missed Dose Closely monitor serum sodium levels and urine output; fluid restriction is recommended. Preoperative doses may be given 2 hours prior to the scheduled procedure. See Table 1 for volume of diluent to use. administration route. Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. If the product has not been used for a period of 1 week, re-prime the pump by pressing once.Instruct patient on the proper technique for administering the nasal spray. Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. A woman who took both desmopressin and ibuprofen was found in a comatose state. Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). Intranasal: A woman who took both desmopressin and ibuprofen was found in a comatose state. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Sulindac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Intermittent intravenous infusionFor adults and children weighing greater than 10 kg, dilute dose in 50 mL of 0.9% Sodium Chloride for injection. The pharmacokinetics of 400 microg of oral desmopressin in elderly patients with nocturia, and the correlation between the absorption of desmopressin and clinical effect. IV injection due to hypotension, bradycardia, and arrhythmias. 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. Guidelines describe preemptive desmopressin administration to prevent sodium overcorrection. Available for Android and iOS devices. Usual dilution: 0.1 mcg/mL. The recommended dose for women is lower than for men because women are more sensitive to the effects of desmopressin sublingual tablet and had a higher risk of hyponatremia with the 55.3 mcg dose in clinical trials. Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Although the manufacturer states that nasal congestion does not affect the absorption of intranasal desmopressin, some clinicians recommend a higher dose. A woman who took both desmopressin and ibuprofen was found in a comatose state. Following an intranasal dose of 1.66 mcg of desmopressin for nocturia, the median apparent terminal half-life was 2.8 hours; the half-life range in patients with an eGFR above 50 mL/minute/1.73 m2 was 1.4 to 3.8 hours. 2022 Mar 2;12(3):389. doi: 10.3390/biom12030389. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Monitor blood pressure during desmopressin administration, particularly in persons with coronary artery disease (insufficiency) and/or hypertension; desmopressin may cause hypotension (with compensatory increase in heart rate) or hypertension. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Urine, for measurements of volume and osmolality, was collected in predetermined intervals before and until 12 h after dosing. BJU Int. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. What is the difference in Nocdurna dosage between men and women. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Indomethacin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. SEQUENTIAL THERAPY : Refers to the act of replacing a parenteral version of a medication with its oral counterpart. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. <>
Oxaprozin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 3 months and older: Dependent on route of administration and indication for therapy.Less than 3 months: Safety and efficacy have not been established. LV>T6If7>LYJTgJ^kyf>[7Sz]>mCh^3r3a2Lmm$9_5y/;D|s
}3a7+NGv46p?MISiZ?dV?pmSosEIN.6DLY}%OL!+Cuf^C;\EvwgOv|2> V,>1w|>>O[[ej,UdSg,ufiEI'&c3Y_$x_'Ifm9s;KY|{AuLTiv[V>n~>r`-@Z(^++Gj~Stsz|6jmm/1dEIz$+ZE7c0rw@GRt=%K2*#g`9'Jp?Hol+c/1K6//1-=d#~t*8t)~H0E>ue)'U'$L Federal government websites often end in .gov or .mil. 0.1 to 0.4 mL via rhinal tube intranasally twice a day. Desmopressin: Corticosteroids (Systemic) may enhance the hyponatremic . 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. Disclaimer. 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. Bendroflumethiazide; Nadolol: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. For continuous infusions, conc. 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. Maintenance dose range: 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. When switching between formulations, the below text is meant as guidance for starting dose. Olmesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. It acts on the kidneys to reduce the flow of urine. For bleeding, desmopressin increases the blood levels of factor VIII and von Willebrand . Medication therapies A nurse cares for a client receiving vancomycin IV therapy. Intranasal: Controls bleeding in certain types of hemophilia and von Willebrand's disease Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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: Dosing, contraindications, side effects, and pill - Epocrates doi: 10.1136/tsaco-2021-000852. Indications: Hemophilia (increases factor VIII levels): 0.3 mcg/kg in 50ml normal saline over 15-30 minutes. Children more than 12 years of age: 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. 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. hydromorphone dose conversion. desmopressin (des-moe-pres-sin) DDAVP, DDAVP Rhinal Tube, DDAVP Rhinyle Drops, Octostim, Stimate. 50 kg or less: 150 mcg Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Caution should be used when coadministering these agents. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. In infants, doses less than 5 mcg (0.05 mL) may be necessary. Renal concentration capacity testing in children below the age of 1 year should only be performed under carefully supervised conditions in hospital. 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. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration.