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 intranasal solution availability - Pituitary Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. Desmopressin acetate 200 microgram tablets; 10microgram/mL WCHN The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Desmopressin is similar to a hormone that is produced in the body. What is the standard conversion technique to calculate those dosages from a typical. Lithium: (Moderate) The antidiuretic response to desmopressin may be reduced in patients receiving lithium concomitantly. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). Piroxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. Repeat administration should be determined by laboratory response and clinical condition of the patient. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Irbesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Dose range is 0.1 to 0.8 mg daily. The tendency toward tachyphylaxis (lessening of response) with repeated administration given more frequently than every 48 hours should be considered in treating each patient. Intranasal: Plasminogen activator activity increases after intravenous desmopressin, but clinically significant fibrinolysis has not been detected in patients treated with desmopressin. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. PDF Last Approval Date: Policy Title: Pharmacist-Managed Intravenous to Usual dilution: 0.1 mcg/mL. 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. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. Twist off the seal from the dropper. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Olmesartan; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient. <> Desmopressin: Uses, Interactions, Mechanism of Action - DrugBank Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. The concentration-time curve after 2 microg intravenous desmopressin was best described using a biexponential term. Monitor patients for signs or symptoms of hypersensitivity reactions during administration, interrupt treatment should a reaction occur, and manage medically. Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Commonly central DI is treated with desmopressin. This places the solution in the nasal cavity and not down your throat.After use, reseal the dropper tip and close the bottle. During treatment with DDAVP Injection, assess serum sodium, bleeding time, factor VIII coagulant activity, ristocetin cofactor activity, and von Willebrand antigen to ensure that adequate levels are being achieved. Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. % However, individualized dosing is recommended due to high inter-patient variability in response. wt. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Drugs; . A woman who took both desmopressin and ibuprofen was found in a comatose state. 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. Adjust for an adequate diurnal rhythm of urine output. government site. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Persons with renal disease may be at increased risk for low sodium concentrations, fluid overload, and electrolyte abnormalities. A woman who took both desmopressin and ibuprofen was found in a comatose state. Baseline renal function should be assessed. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. 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 morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Desmopressin is contraindicated in persons with moderate to severe renal impairment (CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2) and renal failure. Desmopressin acetate 200 microgram tablets; 10microgram/mL WCHN prepared solution; 4microgram/mL injection solution - SA Neonatal Medication Guidelines | SA Health Medication guideline for the management of neonates requiring desmopressin acetate. Preoperative doses may be given 2 hours prior to the scheduled procedure. Carbamazepine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including carbamazepine. DOSAGE AND ADMINISTRATION Hemophilia A and von Willebrand's Disease (Type I): Desmopressin Acetate Injection 4 mcg/mL 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. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Geriatric patients 65 years of age and older treated with desmopressin for nocturia had a higher incidence of hyponatremia compared to patients less than 65 years old; therefore, monitor serum sodium more frequently in these patients. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). Einstein (Sao Paulo). The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Telmisartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Proposed sites of these receptors include endothelial cells, megakaryocytes, blood monocytes, and mast cells. For the treatment of hypothyroidism of any etiology, except during the recovery phase of subacute thyroiditis; used as a replacement in primary (thyroidal), secondary (pituitary), tertiary (hypothalamic), congenital (cretinism), or acquired hypothyroidism. I would recommend making an appointment with your regular doctor to see what might be causing this. 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. %PDF-1.7 The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. desmopressin (des-moe-pres-sin) DDAVP, DDAVP Rhinal Tube, DDAVP Rhinyle Drops, Octostim, Stimate. In addition, in vitro studies with human placenta demonstrate poor placental transfer of desmopressin. 8600 Rockville Pike Desmoperssin is the drug of choice for treatment of central diabetes insipidus and most commonly it is used as intranasal spray. FOIA 1999 Dec;84 Suppl 1:5-8 Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. 6 years or older: 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). Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Levothyroxine Sodium Injection (levothyroxine sodium) dose - PDR 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 frequency of dosing varies with patient responses. A woman who took both desmopressin and ibuprofen was found in a comatose state. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. Clin Endocrinol (Oxf). Monitor blood pressure and pulse during infusion. A woman who took both desmopressin and ibuprofen was found in a comatose state. Aliskiren; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 0.2 to 0.6 mg orally once daily before bedtime. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Increased FVIII and vWF levels are thought to be due to their release from endogenous reservoirs and not increased synthesis since the response is so rapid. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. May repeat dose if needed. Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). Intranasal: 5 mcg/day as a single dose or in 2 divided doses. Captopril; 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. Azelastine; Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 150 mcg into 1 nostril once for a total dose of 150 mcg. 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. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Would you like email updates of new search results? Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin is contraindicated in persons with hyponatremia or a history of hyponatremia, polydipsia, concomitant loop diuretic or systemic or inhaled corticosteroid therapy, known or suspected syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and other illnesses that can cause fluid and electrolyte imbalance, such as gastroenteritis, salt-wasting nephropathies, or systemic infection. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Acetaminophen; Dextromethorphan; 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. Monitor serum sodium concentrations within 1 week and then approximately 1 month after treatment initiation and periodically thereafter. KEEP REFRIGERATED AT 2 to 8C (36 to 46F). Tricyclic antidepressants: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including tricyclic antidepressants. Administer with a 0.22 micron filter. 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. 50 kg or less: 150 mcg A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin is in a class of medications called hormones. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . A woman who took both desmopressin and ibuprofen was found in a comatose state. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Most adults require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. IV, PO, and PR Acetaminophen: A Quick Comparison - Pharmacy Times Put the other end of the tube into the patients mouth; the patient should hold their breath.Tilt the patient's head back and have them blow with a short strong puff through the tube. Initiate at low dose and increase as necessary. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. Select one or more newsletters to continue. Desmopressin (Injection Route) Side Effects - Mayo Clinic 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. celebrity wifi packages cost. Background. In this study, efficacy and side effects of oral desmopressin. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The mean (+/- S.D.) 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. desmopressin iv to po conversion Initially, 0.2 mg PO once daily at bedtime. After a 300 mcg intranasal dose of desmopressin levels of Factor VIII and vWF remain greater than 30 units/dL for 8 hours. 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. They should also avoid drinks containing caffeine and alcohol before bedtime. The study had an open, randomised, four-way cross-over design. C. The pharmacist must enter Epic order comments stating "IV to PO Conversion per P&T policy for all interchanged orders. Codeine; Phenylephrine; Promethazine: (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. Desmopressin acetate | CHEO ED Outreach Monitor patients closely during the initial dose titration period. Vincristine Liposomal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Diabetes insipidus: 2-4 mcg/day IV push or SC. Intranasal: Controls bleeding in certain types of hemophilia and von Willebrand's disease Betamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. DDAVP will also stop bleeding in hemophilia A patients with episodes of spontaneous or trauma-induced injuries such as hemarthroses, intramuscular hematomas or mucosal bleeding. Oral dosage (capsules and tablets) Adults Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Use combination with caution, and monitor patients for signs and symptoms 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. Guidelines describe preemptive desmopressin administration to prevent sodium overcorrection. PDF Converting oral to intravenous or subcutaneous infusions - APPM 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. 4 0 obj Desmopressin works by limiting the amount of water passed in the urine. 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 iv to po conversion - hss.ge 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Pharmacologic: antidiuretic hormones + + + Indications + + PO, SC, IV, Intranasal: Treatment of diabetes insipidus caused by a deficiency of vasopressin.