5 to 40 mcg spray intranasally twice a day or The presence of platelet-vWF and normally functioning platelet glycoprotein (GP) IIb/IIIa seem to be essential for desmopressin's effect on platelets. Monoamine oxidase inhibitors: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia and SIADH including monoamine oxidase inhibitors (MAOIs). 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. Which lab value should prompt the nurse to question a medication dosage increase? Nclex ATI Live Review - pearsonvue/NCLEX On day of exam - Bring a valid eCollection 2022. News Article Holder | Society for Endocrinology Lansoprazole; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Prilocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. 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. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. 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. Meclofenamate Sodium: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. Consider other treatment options for this condition. % Adjust dose based upon response to treatment estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. If Desmopressin Acetate Injection 4 mcg/mL is used preoperatively, it should be administered 30 minutes prior to the scheduled procedure. Fluticasone; Vilanterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. HHS Vulnerability Disclosure, Help IV: 0.3 mcg/kg once slowly over 15-30 minutes. Peak plasma concentration (Cmax) was 6.2 (5.1-7.5) pg/ml at night and 6.6 (5.5-7.9) pg/ml in the daytime. Ensure the serum sodium concentration is within normal limits prior to starting or resuming desmopressin therapy. C. The pharmacist must enter Epic order comments stating "IV to PO Conversion per P&T policy for all interchanged orders. 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. 0.3 mcg/kg/dose (Max: 20 mcg/dose) IV once. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Dosage form: injection Drug class: Antidiuretic hormones Medically reviewed by Drugs.com. Carbetapentane; Phenylephrine; Pyrilamine: (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. Also remove sticky note when IV to po is addressed. Initiate at low dose and increase as necessary. Idiopathic partial central diabetes insipidus. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. A woman who took both desmopressin and ibuprofen was found in a comatose state. The hemostatic effects of desmopressin are mediated through V2 receptor agonist activity, as patients with nephrogenic diabetes insipidus, who lack this receptor, do not have a hemostatic response to desmopressin. Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. xTMk1?DFh!PiHhmz(=lk;p"v< Fobt7t?@IFT];XaYV={~w ^JLAIIG\G\m$XJe@xH8!ZDhrN*'VH4'J.cq 'A%;v}q+i+&L 44qDxR)o3 Repeat administration should be determined by laboratory response and clinical condition of the patient. 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. 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. Rapid IV bolus *Ovv]pu}gz$3 Desmopressin increases plasma factor VIII (FVIII) and von Willebrand factor (vWF) to a greater extent than equivalent weights of vasopressin. DDAVP Nasal Spray (desmopressin acetate) Rx only DESCRIPTION DDAVP Nasal Spray (desmopressin acetate) is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin (ADH), an antidiuretic hormone affecting renal water conservation. Also known as antidiuretic hormone (ADH), vasopressin is secreted by the hypothalamus in response to hyperosmolarity, volume depletion, stress (emotional or physiological), certain drugs, and painful stimuli. If administered more than once a day, adjust for an adequate diurnal rhythm of urine output. A woman who took both desmopressin and ibuprofen was found in a comatose state. Propranolol; 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. Hydrocortisone (systemic): Drug information - UpToDate Caution should be exercised when desmopressin is administered to a woman who is breast-feeding. Only start or resume therapy in patients with a normal serum sodium concentration. How can you convert an orally administered dose to intraperitoneal 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. 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. 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. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Vasopressin, ADH: (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 vasopressin, ADH only with careful patient monitoring. Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Fatal anaphylaxis has been reported with intravenous desmopressin. 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. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. DDAVP ( desmopressin) is a synthetic analog of vasopressin (antidiuretic hormone) that promotes release of factor VIII Reversing anticoagulation and achieving hemostasis after cardiopulmonary bypass In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. 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. Pharmacologic: antidiuretic hormones + + + Indications + + PO, SC, IV, Intranasal: Treatment of diabetes insipidus caused by a deficiency of vasopressin. The volume of diluent is weight-based. 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. 2005 Apr;95(6):804-9. doi: 10.1111/j.1464-410X.2005.05405.x. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. wt. More than 50 kg: 150 mcg in each nostril. Serum concentrations of potassium, sodium, and creatinine do not change following the administration of desmopressin, and urinary excretion of potassium and sodium also remains the same. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Adjust doses based on patient's diurnal pattern of response. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. IV injection due to hypotension, bradycardia, and arrhythmias. Budesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 1 to 2 mcg IV every 6 to 8 hours in combination with hypertonic saline. If doses other than these are required, the rhinal tube delivery system may be used.One spray (10 mcg) has an antidiuretic activity of about 40 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. 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 mean (95% CI) AUC at night was 302 (272-335) pg x h/ml and in the day was 281 (253-312) pg x h/ml. Desmoperssin is the drug of choice for treatment of central diabetes insipidus and most commonly it is used as intranasal spray. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. Repeat administration should be determined by laboratory response and clinical condition of the patient. DDAVP, Stimate (desmopressin) dosing, indications, interactions *L#n~i V3{kf_t.wjO_KgImL%4+GJ+Pp QsWAd._e7p!90&z {c`Kk;swZ/Nf{s~d? Intranasal desmopressin has an antidiuretic effect of about one-tenth that of an equivalent dose administered by injection. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. News Article Holder This page will generate the the news article from the ID supplied in the URL. Dosing: Diabetes Insipidus Diabetes insipidus: 2-4 mcg/day IV push or SC. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fenoprofen: (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. Generic:- Closed containers will maintain stability for 3 weeks at controlled room temperature (68 to 77 degrees F)- Refrigerate (between 36 and 46 degrees F)DDAVP:- Discard product if it contains particulate matter, is cloudy, or discolored- Store in refrigerator at 2 to 8 degrees C (36 to 46 degrees F)Minirin:- Store at 77 degrees F; excursions permitted to 59-86 degrees F- Store uprightNocdurna:- Product should always be stored in the blister and only removed immediately before use- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in the original carton to protect from lightNoctiva:- Product must be used within 60 days after removal from refrigeration to room temperature (77 degrees F)- Store in refrigerator (36 to 46 degrees F), excursions permitted between 32 to 59 degrees F- Store uprightStimate:- Store at room temperature (up to 77 degrees F)- Store upright. 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. government site. endobj Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Blood pressure and heart rate monitoring during infusion is recommended. PDF Intravenous Medication Guidelines for Adults - Ventura County, California Desmopressin is administered orally, intranasally, or parenterally (intravenous or subcutaneously). The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Candesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Amlodipine; 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. May repeat dose if needed. Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Medication guideline for the management of neonates requiring desmopressin acetate. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. You can adjust the side column for all the news articles in the 'side column' tab above 1. Do not transfer any remaining solution to another bottle. The study had an open, randomised, four-way cross-over design. Treatment with ddAVP improves platelet-based coagulation in a rat model of traumatic hemorrhagic shock. Taking control of severe hyponatremia with DDAVP - EMCrit Project The pharmacokinetic profile of desmopressin is biexponential. Greatly enhanced ADH activity. Caution should be used when coadministering these agents. When DDAVP /Desmopressin Injection is used for diagnostic purposes, fluid intake must be limited and not exceed 0.5 litres from 1 hour before until 8 hours after administration. Ddavp, Nocdurna, Octostim. Diabetes Insipidus: < 12 years: No definitive dosing available. Severe allergic reactions, including anaphylaxis, have been reported with intravenous and intranasal desmopressin. The previously recommended dose: 20 mcg (0.2 mL) intranasally of the 0.01% nasal solution at bedtime, with one-half of the dose administered into each nostril. 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 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. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. SEQUENTIAL THERAPY : Refers to the act of replacing a parenteral version of a medication with its oral counterpart. 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. Rotoli BM, Visigalli R, Ferrari F, Ranieri M, Tamma G, Dall'Asta V, Barilli A. Biomolecules. 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. Desmopressin acetate 100 microgram Tablet - medicines Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 0.02 mg IN, 0.2 mg PO and 0.4 mg PO) have a similar, pronounced pharmacodynamic effect on urine volume and urine osmolality. DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. desmopressin iv to po conversion - dthofferss.com Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The bioavailability was 0.08%. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. desmopressin iv to po conversion - MedHelp Oral dosage (capsules and tablets) Adults Desmopressin: Corticosteroids (Systemic) may enhance the hyponatremic . Intranasal: 5 mcg/day as a single dose or in 2 divided doses. A woman who took both desmopressin and ibuprofen was found in a comatose state. What is the difference in Nocdurna dosage between men and women. endobj Caution should be used when coadministering these agents. 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. e-N;CM_[9,jPUO'@O%W]I,7wO;~ -O{GOiZb]]qJy=q4/I3>1&p#!EoA2hF"H kn.u,yQg Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). Commonly central DI is treated with desmopressin. 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Chlorpheniramine; 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. For a patient requiring volume resuscitation, a large volume of normal saline could be . Consider other treatment options for this condition. Blood samples were taken before and at predetermined time points up to 12 h after dosing. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Medically reviewed by Drugs.com. 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. Two children with diabetes insipidus had decreasing desmopressin requirements with lamotrigine initiation. Vasopressin (ADH) and AnalogsVasopressin analogs, Synthetic structural analog of vasopressin (antidiuretic hormone or ADH); more potent and much longer acting than vasopressin; many dosage forms including oral, injectable, sublingual, and intranasal formsUsed for the treatment of central diabetes insipidus, primary nocturnal enuresis (PNE), spontaneous bleeding or trauma-induced hemorrhage, bleeding prophylaxis (e.g., surgical bleeding), hemophilia A or mild to moderate von Willebrand's disease, and nocturia due to nocturnal polyuria in adultsThe intranasal formulation is no longer indicated to treat PNE secondary to reports of hyponatremic-related seizures sometimes resulting in death, DDAVP, Minirin, Nocdurna, Noctiva, Stimate, DDAVP Nasal Sol: 0.1mg, 1mLDDAVP/Desmopressin/Desmopressin Acetate Intravenous Inj Sol: 1ml, 4mcgDDAVP/Desmopressin/Desmopressin Acetate Oral Tab: 0.1mg, 0.2mgDDAVP/Desmopressin/Desmopressin Acetate Subcutaneous Inj Sol: 1ml, 4mcgDDAVP/Desmopressin/Desmopressin Acetate/Minirin/Noctiva/Stimate Nasal Spray Met: 0.1mg, 0.1mL, 0.75mcg, 1mL, 1.5mg, 1.5mcgNocdurna Sublingual Tablet, SL: 27.7mcg, 55.3mcg. If used preoperatively, administer 2 hours before surgery. 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. 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. Accessibility Intranasal: Controls bleeding in certain types of hemophilia and von Willebrand's disease Indications and dose Diabetes insipidus, treatment By mouth Child 1-23 months Initially 10 micrograms 2-3 times a day, adjusted according to response; usual dose 30-150 micrograms daily. Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or enteral nutrition and/or receiving oral medications Infection does not require IV antibiotics Afebrile (< 100.4F in the last 24 hours) Received 24 hours of IV antibiotics Plasminogen activator activity increases after intravenous desmopressin, but clinically significant fibrinolysis has not been detected in patients treated with desmopressin. A woman who took both desmopressin and ibuprofen was found in a comatose state. Gently breathe in through the nose and out through the mouth several times.Wipe the nasal applicator using a clean tissue and replace the cap on the bottle.To avoid the spread of infection, do not use the container for more than 1 person.Do not co-administer with other intranasal products.Discard nasal spray 60 days after opening. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 8600 Rockville Pike ea1`-@te3;plr*5L%5Ko=UNed Available for Android and iOS devices. Azilsartan; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. IV: 0.3 mcg/kg once slowly over 15-30 minutes. The resultant increases in FVIII and vWF are similar to those seen with replacement therapy using blood products. If the product has not been used for more than 3 days, re-prime by pumping 2 actuations into the air.Instruct the patient to blow their nose, tilt the head back slightly, and insert the nasal applicator into the left or right nostril, keeping the nasal applicator upright. Oral: 0.05 mg twice a day. Loop diuretics: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Acetaminophen; Chlorpheniramine; 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. 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. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. What is the difference in Nocdurna dosage between men and women. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. His endocranologist only wants him to use it one time a day, but the problem is he goes to the bathroom sometimes every 15 minutes!!! If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. . 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. Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. 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. The initial response is reproducible if DDAVP is administered every 2 to 3 days. There is no increase in activity with doses greater than 0.4 mcg/kg, despite increases in desmopressin concentrations. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Guardrail Drug Requires documentation of two (2) RN's for double-checking. Blood pressure and heart rate monitoring during infusion is recommended. peak plasma concentration (Cmax) was 4 (+/- 3.85) pg/mL for the 0.83 mcg dose and 9.11 (+/- 6.90) pg/mL for the 1.66 mcg dose. Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. Chlorpheniramine; 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. For continuous infusions, conc. If there are dry nights after Desmopressin is used, continue using it for 3 months and then review your child's progress. Children more than 12 years of age: 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.