Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 1/10 of intranasal dose; restrict fluid intake nocturnal enuresis -, BJU Int. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. Desmopressin is a strong V2 agonist and has no effect on V1 receptors. The site is secure. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Dosage form: injection Drug class: Antidiuretic hormones Medically reviewed by Drugs.com. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Careers. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. 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. 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. The pharmacokinetic profile of desmopressin is biexponential. Twist off the seal from the dropper. 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. According to the Beers Criteria, desmopressin is considered a potentially inappropriate medication (PIM) in geriatric adults and avoidance is recommended for treating nocturia or nocturnal polyuria because there is a high risk of hyponatremia and safer alternatives are available. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Quinapril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. THOSE AT INCREASED RISK FOR HYPONATREMIA: 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. 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. If used preoperatively, administer 30 minutes prior to the procedure. A woman who took both desmopressin and ibuprofen was found in a comatose state. Fill in the blank - Do not enter the label - Rounding - Verify answer - Conversions - Practice questions. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Wash the rhinal tube in water and shake well, until no water is left in the tube.To avoid the spread of infection, do not use the container for more than 1 person.For 2.5 mL bottles, discard after 25 sprays (doses) because the amount delivered thereafter per spray may be substantially less than the recommended dose. Ther Drug Monit. Conversion of IV Midazolam. FOIA Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. 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. Greatly enhanced ADH activity. Select one or more newsletters to continue. 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. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. and transmitted securely. Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Desmopressin is found in breast milk, but not in significant amounts. 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. 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. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. Following administration of intranasal desmopressin for nocturia, the median time to peak plasma concentrations (Tmax) was 0.25 hour for the 0.83 mcg dose and 0.75 hour for the 1.66 mcg dose. Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. 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. There is no information on the effects of desmopressin on the breast-fed infant or on milk production. For a patient requiring volume resuscitation, a large volume of normal saline could be . A woman who took both desmopressin and ibuprofen was found in a comatose state. In addition, in vitro studies with human placenta demonstrate poor placental transfer of desmopressin. CAREFULLY BEFORE ACCESSING OR USING THIS SITE. Copyright 1993-2021 Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. Formoterol; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Carbetapentane; 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. <>/Metadata 2732 0 R/ViewerPreferences 2733 0 R>> 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. 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. YES. Persons with vWD subtype 1C, which is characterized by a shorted vWF half-life, may require alternative management in the setting of surgery. 1 to 2 mcg IV twice a day or Persons with renal disease may be at increased risk for low sodium concentrations, fluid overload, and electrolyte abnormalities. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. anaphylactoid reactions / Rapid / 0-1.0anaphylactic shock / Rapid / 0-1.0seizures / Delayed / Incidence not knownwater intoxication / Delayed / Incidence not knowncoma / Early / Incidence not knownthrombosis / Delayed / Incidence not knownthromboembolism / Delayed / Incidence not knownstroke / Early / Incidence not knownmyocardial infarction / Delayed / Incidence not known, hyponatremia / Delayed / 0.9-12.0hypertension / Early / 1.7-2.6photophobia / Early / 0-2.0conjunctivitis / Delayed / 0-2.0confusion / Early / Incidence not knownelevated hepatic enzymes / Delayed / Incidence not knownhypotension / Rapid / Incidence not knownsinus tachycardia / Rapid / Incidence not knownpalpitations / Early / Incidence not knowninfertility / Delayed / Incidence not knownbalanitis / Delayed / Incidence not knowntolerance / Delayed / Incidence not known, xerostomia / Early / 0-14.0rhinitis / Early / 3.0-8.0headache / Early / 2.0-5.0pharyngitis / Delayed / 2.3-3.8dizziness / Early / 0-3.0epistaxis / Delayed / 2.0-3.0nasal congestion / Early / 1.4-2.9sneezing / Early / 2.3-2.6back pain / Delayed / 1.1-2.3chills / Rapid / 0-2.0asthenia / Delayed / 0-2.0rhinalgia / Early / 2.0-2.0ocular pruritus / Rapid / 0-2.0lacrimation / Early / 0-2.0diarrhea / Early / Incidence not knownabdominal pain / Early / Incidence not knowndyspepsia / Early / Incidence not knownnausea / Early / Incidence not knownlethargy / Early / Incidence not knownflushing / Rapid / Incidence not knowncough / Delayed / Incidence not knowninjection site reaction / Rapid / Incidence not knownoligospermia / Delayed / Incidence not known. Do not transfer any remaining solution to another bottle. Objective: To investigate (1) the pharmacokinetic and pharmacodynamic profiles of desmopressin in men from an age group with a high incidence of nocturia; and (2) circadian variation in the pharmacokinetic parameters. ea1`-@te3;plr*5L%5Ko=UNed However, desmopressin is used off-label as a single injection for uremic bleeding in persons with renal failure. Methods: In infants, doses less than 5 mcg (0.05 mL) may be necessary. hydromorphone dose conversion. Repeat dosing is not recommended; therefore, the risk of toxicities associated with accumulation of desmopressin is expected to be low, especially with single-dose intermittent use and appropriate monitoring. 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. -, Br J Urol. Before Ensure the patient is compliant with fluid restrictions and intake. Tachyphylaxis (lessening of response) with repeated administration (i.e., given more frequently than every 48 hours) may occur. A woman who took both desmopressin and ibuprofen was found in a comatose state. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. DrugBank Accession Number. Carbetapentane; Diphenhydramine; 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. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. 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. [33605], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). 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. Monitor patients closely during the initial dose titration period. 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. For antimicrobial interchanges: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per protocol.
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