Desmopressin
- Atc Codes:H01BA02
- CAS Codes:62357-86-2#62288-83-9#16679-58-6
- PHARMGKB ID:62357-86-2#62288-83-9#16679-58-6
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Desmopressin, Minirin, Nocutil, Novidin, Octostim; Belgium: Desmopressine, Minrin, Octostim; Bulgaria: Minirin, Presinex; Cyprus: Minirin, Noctissin; Czech Republic: Desmospray, Desmotabs, Minirin; Denmark: Desmomelt, Desmopressin, Minirin, Nocutil, Octostim; Estonia: Desmopressin, Minirin, Octostim; Finland: Minirin, Octostim; France: Defirin, Desmogalen, Desmopressine, Minirin, Nocturin, Octim; Germany: Desmogalen, Desmopatin, Desmopressin, Desmospray, Desmotabs, Minirin, Nocturin, Nocutil, Octostim; Greece: DDAVP, Defirin, Esmon, Minirin, Desmoprol; Hungary: Adiuretin, Minirin, Nocutil, Octostim; Ireland: DDAVP, Desmospray, Desmotabs, Noctissin, Nordurine, Octostim; Italy: Desmopres, Emosint, Minirin/DDAVP; Latvia: Desmopressin, Minirin, Octostim; Lithuania: Desmopressin, Minirin, Octostim; Luxembourg: Minirin, Minrin; Malta: DDAVP, Desmomelt, Desmopressin, Minirin; Netherlands: Adiuretin, Desmopressine, Minirin, Minrin, Octostim; Poland: Adiuretin, Minirin, Nocutil; Portugal: DDAVP Desmopressin, Desmopressina, Desmospray, Minirin; Romania: Desmopresina, Desmopressin, Minirin; Slovakia: Desmopressin, Minirin; Slovenia: Dezmopresinijev, Minirin; Spain: Desmopresina, Minurin, Octostim; Sweden: Desmopressin, Minirin, Minurin, Nocutil, Octostim; UK: DDAVP, Desmomelt, Desmopressin, Desmospray, Desmotabs, Octim.
North America
Canada: DDAVP, Desmopressin, Minirin, Octostim; USA: DDAVP, Desmopressin, Minirin, Stimate.
Latin America
Argentina: Desmopresin, Emosint, Octostim; Mexico: Desmopresina, Minirin, Nafiset, Octostim.
Asia
Japan: Desmopressin.
Drug combinations
Chemistry
Desmopressin Acetate: C~48~H~68~N~14~O~14~S~2~ 3H~2~O. Mw: 1183.31. (1) Vasopressin, 1-(3-mercaptopropanoic acid)-8-D-arginine-, monoacetate (salt), trihydrate; (2) 1-(3-Mercaptopropionic acid)-8-D-arginine-vasopressin monoacetate (salt) trihydrate. CAS-62357-86-2; CAS-62288-83-9 (anhydrous); CAS-16679-58-6 (desmopressin)(1977).
Pharmacologic Category
Hormones and Synthetic Substitutes; Pituitary. Antihemorrhagic Agents; Hemostatics. Synthetic Vasopressin Analog. Antidiuretic Agent. (ATC-Code: H01BA02).
Mechanism of action
Increases cAMP in renal tubular cells, which increases water permeability resulting in decreased urine volume and increased urine osmolality. Also increases plasma levels of von Willebrand factor, factor VIII, and t-PA contributing to a shortened APTT and bleeding time.
Therapeutic use
To prevent or control polydipsia, polyuria, and dehydration in diabetes insipidus caused by a deficiency of endogenous posterior pituitary vasopressin (antidiuretic hormone)(neurohypophyseal diabetes insipidus) and to manage temporary polyuria and polydipsia associated with trauma or surgery in the pituitary region. Maintenance of hemostasis and control of bleeding in hemophilia A with factor VIII coagulant activity levels >5% and mild-to-moderate classic von Willebrand disease (type 1) with factor VIII coagulant activity levels >5% (the drug is designated an orphan drug by the FDA for use in these conditions). May also be used for the management of primary nocturnal enuresis (intranasal administration is no longer indicated due to risk of serious hyponatremia that may result in seizures and death, particularly in children).
Pregnancy and lactiation implications
Adverse events not observed in animal reproductive studies. Although the drug has been used safely during pregnancy, potential therapeutic benefits must be weighed against possible risks. Should be used with caution during lactation.
Unlabeled use
Uremic bleeding associated with acute or chronic renal failure. Prevention of surgical bleeding in uremia.
Contraindications
Hypersensitivity to desmopressin or any component of the formulation. Hyponatremia or history of hyponatremia. Renal impairment.
Warnings and precautions
The FDA withdrew its prior approval for the treatment of primary nocturnal enuresis from desmopressin intranasal preparations due to hyponatremia-related seizures. Oral administration of the drug is generally well tolerated. Infrequent and mild adverse effects with intranasal or parenteral administration reported (rare reports of thrombotic events following injection of the drug in patients predisposed to such events). Since desmopressin is a potent antidiuretic, fluid restriction is recommended, particularly in pediatric and geriatric patients, to reduce the risk of potential water intoxication and hyponatremia. Severe allergic reactions, including anaphylaxis, reported rarely with parenteral and intranasal desmopressin. Risk factors for hyponatremia with desmopressin use include cystic fibrosis, polydipsia, heart failure, young age, advanced age, inappropriate high fluid intake with desmopressin administration, a larger than recommended dose, and medications which increase thirst or cause SIADH. Injection and high concentration spray (1.5 mg/mL) are not recommended for use in hemophilia B, type 2B von Willebrand disease, severe classic von Willebrand disease (type 1), or patients with factor VIII antibodies. In general, the injection and the high concentration spray are not recommended for use in patients with ≤5% factor VIII activity level, although it may be considered in selected patients with activity levels between 2% and 5%.