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Pronunciation
(des moe PRES in)
Generic Available (U.S.)
Yes
Index Terms
Brand Names: U.S.
Brand Names: Canada
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Injection: Treatment of diabetes insipidus; maintenance of hemostasis and control of bleeding in hemophilia A with factor VIII coagulant activity levels >5% and mild-to-moderate classic von Willebrand's disease (type 1) with factor VIII coagulant activity levels >5%
Nasal solutions (DDAVP® Nasal Spray and DDAVP® Rhinal Tube): Treatment of central diabetes insipidus
Nasal spray (Stimate®): Maintenance of hemostasis and control of bleeding in hemophilia A with factor VIII coagulant activity levels >5% and mild-to-moderate classic von Willebrand's disease (type 1) with factor VIII coagulant activity levels >5%
Tablet: Treatment of central diabetes insipidus, temporary polyuria and polydipsia following pituitary surgery or head trauma, primary nocturnal enuresis
Use: Unlabeled
Uremic bleeding associated with acute or chronic renal failure; prevention of surgical bleeding in patients with uremia
Pregnancy Risk Factor
B
Pregnancy Considerations
Adverse events were not observed in animal reproduction studies. There are no adequate and well-controlled studies in pregnant women. Anecdotal reports suggest congenital anomalies and low birth weight. However, causal relationship has not been established. Desmopressin has been used safely during pregnancy.
Lactation
Excretion in breast milk unknown/use caution
Contraindications
Hypersensitivity to desmopressin or any component of the formulation; hyponatremia or a history of hyponatremia; moderate-to-severe renal impairment (Clcr<50 mL/minute)
Canadian labeling: Additional contraindications (not in U.S. labeling): Type 2B or platelet-type (pseudo) von Willebrand's disease (injection, intranasal, oral, sublingual); known hyponatremia, habitual or psychogenic polydipsia, cardiac insufficiency or other conditions requiring diuretic therapy (intranasal, sublingual); nephrosis, severe hepatic dysfunction (sublingual); primary nocturnal enuresis (intranasal)
Warnings/Precautions
Concerns related to adverse effects:
• Allergic reactions (injectable and intranasal formulations): Severe reactions resembling hypersensitivity (eg, anaphylaxis) reactions have occurred rarely with I.V. and intranasal administration.
• Hyponatremia: Use may rarely lead to hyponatremia and extreme decreases in plasma osmolality, resulting in seizures, coma, and death. Risk factors for hyponatremia with desmopressin use include cystic fibrosis, renal dysfunction, heart failure, young age, advanced age, inappropriate high fluid intake with desmopressin administration, a larger than recommended dose, and concomitant use of medications known to either increase thirst or cause syndrome of inappropriate ADH secretion (SIADH). Fluid restriction during use is recommended.
• Thrombotic events: Acute cerebrovascular thrombosis and acute myocardial infarction have occurred (rare); use with caution in patients predisposed to thrombus formation.
Disease-related concerns:
• Cardiovascular disease: Use with caution in patients with coronary artery insufficiency or hypertensive cardiovascular disease; may increase or decrease blood pressure leading to changes in heart rate.
• Polydipsia (habitual or psychogenic): Use with caution in patients with habitual or psychogenic polydipsia. These patients are at greater risk of hyponatremia. Use in these patients is contraindicated in Canadian labeling.
• von Willebrand's disease type 2B: Patients with type 2B von Willebrand's disease requiring hemostasis should not be treated with desmopressin since use may result in platelet aggregation, thrombocytopenia, and possibly thrombosis.
Special populations:
• Elderly: Fluid intake should be adjusted downward in the elderly to decrease the possibility of water intoxication and hyponatremia.
• Pediatrics: Fluid intake should be adjusted downward in very young patients to decrease the possibility of water intoxication and hyponatremia.
Dosage form specific issues:
• Injection and high concentration spray (1.5 mg/mL): Not for use in hemophilia B, type 2B von Willebrand disease, severe classic von Willebrand disease (type 1), or in patients with factor VIII antibodies. In general, the injection and high concentration spray are also 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%.
• Intranasal: Consider alternative route of administration (I.V.) if changes in the nasal mucosa (scarring, edema) occur leading to unreliable absorption.
• Tablet: Patients should be instructed to restrict fluid intake from 1 hour before to 8 hours after taking desmopressin tablets. Consider alternative route of administration (I.V. or intranasal) with inadequate therapeutic response at maximum recommended oral doses.
Appropriate use:
• Interruption of therapy: Therapy should be interrupted if the patient experiences an acute illness (eg, fever, recurrent vomiting or diarrhea), vigorous exercise, or any condition associated with an increase in water consumption.
Other warnings/precautions:
• Long-term effects: Some patients may demonstrate a change in response after long-term therapy (>6 months) characterized as decreased response or a shorter duration of response.
Adverse Reactions
Frequency may not be defined (may be dose or route related).
Cardiovascular: Blood pressure increased/decreased (I.V.), facial flushing
Central nervous system: Headache (2% to 5%), dizziness (intranasal; ≤3%), chills (intranasal; 2%)
Dermatologic: Rash
Endocrine & metabolic: Hyponatremia, water intoxication
Gastrointestinal: Abdominal pain (intranasal; 2%), gastrointestinal disorder (intranasal; ≤2%), nausea (intranasal; ≤2%), abdominal cramps, sore throat
Hepatic: Transient increases in liver transaminases (associated primarily with tablets)
Local: Injection: Burning pain, erythema, and swelling at the injection site
Neuromuscular & Skeletal: Weakness (intranasal; ≤2%)
Ocular: Conjunctivitis (intranasal; ≤2%), eye edema (intranasal; ≤2%), lacrimation disorder (intranasal; ≤2%)
Respiratory: Rhinitis (intranasal; 3% to 8%), epistaxis (intranasal; ≤3%), nostril pain (intranasal; ≤2%), cough, nasal congestion, upper respiratory infection
<1%, postmarketing, and/or case reports: Acute cerebrovascular thrombosis (I.V.), acute MI (I.V.), agitation, allergic reactions (rare), anaphylaxis (rare), balanitis, chest pain, coma, diarrhea, dyspepsia, edema, insomnia, itching eyes, light-sensitive eyes, pain, palpitation, seizure, somnolence, tachycardia, thinking abnormal, vomiting, vulval pain, warmth
Metabolism/Transport Effects
None known.
Drug Interactions
Analgesics (Opioid): May enhance the adverse/toxic effect of Desmopressin. Risk C: Monitor therapy
CarBAMazepine: May enhance the adverse/toxic effect of Desmopressin. Risk C: Monitor therapy
ChlorproMAZINE: May enhance the adverse/toxic effect of Desmopressin. Risk C: Monitor therapy
Demeclocycline: May diminish the therapeutic effect of Desmopressin. Risk C: Monitor therapy
LamoTRIgine: May enhance the adverse/toxic effect of Desmopressin. LamoTRIgine may enhance the therapeutic effect of Desmopressin. Risk C: Monitor therapy
Lithium: May diminish the therapeutic effect of Desmopressin. Desmopressin may increase the serum concentration of Lithium. Risk C: Monitor therapy
Nonsteroidal Anti-Inflammatory Agents: May enhance the adverse/toxic effect of Desmopressin. Risk C: Monitor therapy
Selective Serotonin Reuptake Inhibitors: May enhance the adverse/toxic effect of Desmopressin. Risk C: Monitor therapy
Tricyclic Antidepressants: May enhance the adverse/toxic effect of Desmopressin. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Ethanol: Avoid ethanol (may decrease antidiuretic effect).
Storage
DDAVP®:
Nasal spray: Store at controlled room temperature of 20°C to 25°C (68°F to 77°F). Keep nasal spray in upright position.
Rhinal Tube solution: Store refrigerated at 2°C to 8°C (36°F to 46°F). May store at controlled room temperature of 20°C to 25°C (68°F to 77°F) for up to 3 weeks.
Solution for injection: Store refrigerated at 2°C to 8°C (36°F to 46°F).
Tablet: Store at controlled room temperature of 20°C to 25°C (68°F to 77°F).
DDAVP® Melt (CAN; not available in U.S.): Store at 15°C to 25°C (59°F to 77°F) in original container. Protect from moisture.
Stimate® nasal spray: Store refrigerated at 2°C to 8°C (36°F to 46°F). May store at controlled room temperature of 22°C (72°F) for up to 3 weeks.
Reconstitution
DDAVP®: Dilute solution for injection in 10-50 mL NS for I.V. infusion (10 mL for children ≤10 kg: 50 mL for adults and children >10 kg).
Compatibility
Stable in NS.
Mechanism of Action
In a dose dependent manner, desmopressin increases cyclic adenosine monophosphate (cAMP) in renal tubular cells which increases water permeability resulting in decreased urine volume and increased urine osmolality; increases plasma levels of von Willebrand factor, factor VIII, and t-PA contributing to a shortened activated partial thromboplastin time (aPTT) and bleeding time.
Pharmacodynamics/Kinetics
Onset of action:
Intranasal: Antidiuretic: 15-30 minutes; Increased factor VIII and von Willebrand factor (vWF) activity (dose related): 30 minutes
Peak effect: Antidiuretic: 1 hour; Increased factor VIII and vWF activity: 1.5 hours
I.V. infusion: Increased factor VIII and vWF activity: 30 minutes (dose related)
Peak effect: 1.5-2 hours
Oral tablet: Antidiuretic: ~1 hour
Peak effect: 4-7 hours
Duration: Intranasal, I.V. infusion, Oral tablet: ~6-14 hours
Absorption: Sublingual: Rapid
Bioavailability: Intranasal: ~3.5%; Oral tablet: 5% compared to intranasal, 0.16% compared to I.V.
Half-life elimination: Intranasal: ~3.5 hours; I.V. infusion: 3 hours; Oral tablet: 2-3 hours
Renal impairment: ≤9 hours
Excretion: Urine
Dosage
Children:
Diabetes insipidus:
I.M., I.V., SubQ: Canadian labeling (not in U.S. labeling): Infants and Children ≥3 months: 0.4 mcg (0.1 mL) once daily or one-tenth (1/10) of the maintenance intranasal dose. Fluid restriction should be observed.
I.V., SubQ: Children <12 years: No definitive dosing available. Adult dosing should not be used in this age group; adverse events such as hyponatremia-induced seizures may occur. Dose should be reduced. Some have suggested an initial dosage range of 0.1-1 mcg in 1 or 2 divided doses (Cheetham, 2002). Initiate at low dose and increase as necessary. Closely monitor serum sodium levels and urine output; fluid restriction is recommended.
Intranasal (using 100 mcg/mL nasal solution): Infants and Children 3 months to 12 years: Initial: 5 mcg/day (0.05 mL/day) divided 1-2 times/day; range: 5-30 mcg/day (0.05-0.3 mL/day) divided 1-2 times/day; adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. Note: The nasal spray pump can only deliver doses of 10 mcg (0.1 mL) or multiples of 10 mcg (0.1 mL); if doses other than this are needed, the rhinal tube delivery system is preferred. Fluid restriction should be observed.
Oral:
U.S. labeling: Children ≥4 years: Initial: 0.05 mg twice daily; total daily dose should be increased or decreased as needed to obtain adequate antidiuresis (range: 0.1-1.2 mg divided 2-3 times/day). Fluid restriction should be observed.
Canadian labeling (not in U.S. labeling): Children ≥5 years: Initial: 0.1 mg 3 times/day; total daily dose should be increased or decreased as needed to obtain adequate antidiuresis (range: 0.3-1.2 mg divided 3 times/day). Divide daily doses so that the evening dose is 2 times higher than the morning or afternoon dose to ensure adequate antidiuresis during the night. Fluid restriction should be observed.
Sublingual formulation: Canadian labeling (not in U.S. labeling): Infants and Children ≥3 months: Initial: 60 mcg 3 times/day; total daily dose should be increased or decreased as needed to obtain adequate antidiuresis. Usual maintenance: 60-120 mcg 3 times/day (range: 120-720 mcg divided 2-3 times/day); divide daily doses so that the evening dose is 2 times higher than the morning or afternoon dose to ensure adequate antidiuresis during the night. Fluid restriction should be observed.
Hemophilia A and von Willebrand disease (type 1):
I.V.: Infants and Children ≥3 months: 0.3 mcg/kg by slow infusion; may repeat dose if needed; if used preoperatively, administer 30 minutes before procedure
Canadian labeling (not in U.S. labeling): Maximum I.V. dose: 20 mcg
Note: Adverse events such as hyponatremia-induced seizures have been reported especially in young children using this dosing regimen (Das, 2005; Molnar, 2005; Smith, 1989; Thumfart, 2005; Weinstein, 1989). Fluid restriction and careful monitoring of serum sodium levels and urine output are necessary.
Intranasal (using high concentration spray [1.5 mg/mL]): Infants and Children ≥11 months: Refer to adult dosing.
Nocturnal enuresis:
Oral: Children ≥6 years: 0.2 mg at bedtime; dose may be titrated up to 0.6 mg to achieve desired response. Fluid intake should be limited 1 hour prior to dose until the next morning, or at least 8 hours after administration. Note: In the Canadian labeling, use is approved for patients ≥5 years.
Sublingual formulation: Canadian labeling (not in U.S. labeling): Children ≥5 years: Initial: 120 mcg at bedtime; dose may be titrated up to 360 mcg to achieve desired response. Fluid intake should be limited 1 hour prior to dose until the next morning, or at least 8 hours after administration.
Children ≥12 years and Adults:
Diabetes insipidus:
I.V., SubQ: 2-4 mcg/day (0.5-1 mL) in 2 divided doses or one-tenth (1/10) of the maintenance intranasal dose. Fluid restriction should be observed.
Intranasal (using 100 mcg/mL nasal solution): 10-40 mcg/day (0.1-0.4 mL) divided 1-3 times/day; adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. Note: The nasal spray pump can only deliver doses of 10 mcg (0.1 mL) or multiples of 10 mcg (0.1 mL); if doses other than this are needed, the rhinal tube delivery system is preferred. Fluid restriction should be observed.
Oral:
U.S. labeling: Initial: 0.05 mg twice daily; total daily dose should be increased or decreased as needed to obtain adequate antidiuresis (range: 0.1-1.2 mg divided 2-3 times/day). Fluid restriction should be observed.
Canadian labeling (not in U.S. labeling): Initial: 0.1 mg 3 times/day; total daily dose should be increased or decreased as needed to obtain adequate antidiuresis (range: 0.3-1.2 mg divided 3 times/day). Fluid restriction should be observed.
Sublingual formulation: Canadian labeling (not in U.S. labeling): Initial: 60 mcg 3 times/day; total daily dose should be increased or decreased as needed to obtain adequate antidiuresis. Usual maintenance: 60-120 mcg 3 times/day (range: 120-720 mcg divided 2-3 times/day). Fluid restriction should be observed.
Hemophilia A and mild-to-moderate von Willebrand disease (type 1):
I.V.: 0.3 mcg/kg by slow infusion; if used preoperatively, administer 30 minutes before procedure
Canadian labeling (not in U.S. labeling): Maximum I.V. dose: 20 mcg
Intranasal (using high concentration spray [1.5 mg/mL]): <50 kg: 150 mcg (1 spray); >50 kg: 300 mcg (1 spray each nostril); repeat use is determined by the patient's clinical condition and laboratory work; if using preoperatively, administer 2 hours before surgery
Adults:
Diabetes insipidus: I.M., I.V., SubQ: Canadian labeling (not in U.S. labeling): 1-4 mcg (0.25-1 mL) once daily or one-tenth (1/10) of the maintenance intranasal dose. Fluid restriction should be observed.
Uremic bleeding associated with acute or chronic renal failure (unlabeled use) (Watson, 1984): I.V.: 0.4 mcg/kg over 10 minutes
Prevention of surgical bleeding in patients with uremia (unlabeled use) (Mannucci, 1983): I.V.: 0.3 mcg/kg over 30 minutes
Dosage adjustment in renal impairment: Clcr <50 mL/minute: Use is contraindicated according to the manufacturer; however, has been used in acute and chronic renal failure patients experiencing uremic bleeding or for prevention of surgical bleeding (unlabeled uses) (Mannucci, 1983; Watson, 1984)
Administration: I.M.
Central diabetes insipidus: Withdraw dose from ampul into appropriate syringe size (eg, insulin syringe). Further dilution is not required. Administer as direct injection.
Administration: I.V.
I.V. push: Central diabetes insipidus: Withdraw dose from ampul into appropriate syringe size (eg, insulin syringe). Further dilution is not required. Administer as direct injection.
I.V. infusion:
Hemophilia A, von Willebrand disease (type 1), and prevention of surgical bleeding in patients with uremia (unlabeled) (Mannucci, 1983): Infuse over 15-30 minutes
Acute uremic bleeding (unlabeled) (Watson, 1984): May infuse over 10 minutes
Administration: Other
Intranasal:
DDAVP®: Nasal pump spray: Delivers 0.1 mL (10 mcg); for doses <10 mcg or for other doses which are not multiples, use rhinal tube. DDAVP® Nasal spray delivers fifty 10 mcg doses. For 10 mcg dose, administer in one nostril. Any solution remaining after 50 doses should be discarded. Pump must be primed prior to first use.
DDAVP® Rhinal tube: Insert top of dropper into tube (arrow marked end) in downward position. Squeeze dropper until solution reaches desired calibration mark. Disconnect dropper. Grasp the tube 3/4 inch from the end and insert tube into nostril until the fingertips reach the nostril. Place opposite end of tube into the mouth (holding breath). Tilt head back and blow with a strong, short puff into the nostril (for very young patients, an adult should blow solution into the child's nose). Reseal dropper after use.
SubQ: Central diabetes insipidus: Withdraw dose from ampul into appropriate syringe size (eg, insulin syringe). Further dilution is not required. Administer as direct injection.
Monitoring Parameters
Blood pressure and pulse should be monitored during I.V. infusion
Note: For all indications, fluid intake, urine volume, and signs and symptoms of hyponatremia should be closely monitored especially in high-risk patient subgroups (eg, young children, elderly, patients with heart failure).
Diabetes insipidus: Urine specific gravity, plasma and urine osmolality, serum electrolytes
Hemophilia A: Factor VIII coagulant activity, factor VIII ristocetin cofactor activity, and factor VIII antigen levels, aPTT
von Willebrand disease: Factor VIII coagulant activity, factor VIII ristocetin cofactor activity, and factor VIII von Willebrand antigen levels, bleeding time
Nocturnal enuresis: Serum electrolytes if used for >7 days
Patient Education
Avoid alcohol; may decrease effect of medication. Avoid overhydration; follow prescriber instructions for fluid intake. Report increased weight or swelling of extremities; excessive thirst; unresolved headache; chest pain or palpitation; respiratory difficulty; acute heartburn, nausea, vomiting, or abdominal cramping; CNS changes (agitation, chills, coma, dizziness, insomnia, confusion); or rash. If using intranasal product, inspect nasal membranes regularly and report swelling, redness, irritation, or increased nasal congestion.
Geriatric Considerations
Elderly patients should be cautioned not to increase their fluid intake beyond that sufficient to satisfy their thirst in order to avoid water intoxication and hyponatremia. Under experimental conditions, elderly have been shown to have a decreased responsiveness to vasopressin with respect to its effects on water homeostasis.
Additional Information
10 mcg of desmopressin acetate is equivalent to 40 int. units
Anesthesia and Critical Care Concerns/Other Considerations
Clinical Pearls/Comments: If desmopressin I.V. is given preoperatively, administer 30 minutes prior to surgery. If desmopressin intranasal is given preoperatively, administer 2 hours prior to surgery.
Cardiovascular Considerations
When administered I.V., desmopressin is a vasoconstrictor and may cause acute hypertension.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause dizziness
Mental Health: Effects on Psychiatric Treatment
May decrease lithium's effect on ADH, however, hydrochlorothiazide or amiloride are better choices
Nursing: Physical Assessment/Monitoring
Evaluate for any history of or potential for hyponatremia or renal impairment prior to beginning therapy. Monitor for thromboembolism, hyponatremia, and water intoxication regularly throughout therapy.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Injection, solution, as acetate: 4 mcg/mL (1 mL, 10 mL)
DDAVP®: 4 mcg/mL (1 mL)
DDAVP®: 4 mcg/mL (10 mL) [contains chlorobutanol]
Solution, intranasal, as acetate: 0.1 mg/mL (2.5 mL)
DDAVP®: 0.1 mg/mL (2.5 mL) [contains chlorobutanol; with rhinal tube]
Solution, intranasal, as acetate [spray]: 0.1 mg/mL (5 mL)
DDAVP®: 0.1 mg/mL (5 mL) [contains benzalkonium chloride; delivers 10 mcg/spray]
Stimate®: 1.5 mg/mL (2.5 mL) [contains benzalkonium chloride; delivers 150 mcg/spray]
Tablet, oral, as acetate: 0.1 mg, 0.2 mg
DDAVP®: 0.1 mg, 0.2 mg [scored]
Pricing: U.S. (www.drugstore.com)
Solution (DDAVP)
0.01% (5): $267.98
4 mcg/mL (1): $59.30
4 mcg/mL (10): $473.06
Solution (DDAVP Rhinal Tube)
0.01% (2.5): $154.52
Solution (Desmopressin Ace Rhinal Tube)
0.01% (2.5): $86.36
Solution (Desmopressin Ace Spray Refrig)
0.01% (5): $209.99
Solution (Stimate)
1.5 mg/mL (2.5): $649.01
Tablets (DDAVP)
0.1 mg (30): $151.73
0.2 mg (30): $203.39
Tablets (Desmopressin Acetate)
0.1 mg (30): $86.99
0.2 mg (90): $339.97
References
Asplund R and Aberg H, "Desmopressin in Elderly Subjects With Increased Nocturnal Diuresis: A Two-Month Treatment Study," Scand J Urol Nephrol, 1993, 27(1):77-82.
Brewster UC and Hayslett JP, "Diabetes Insipidus in the Third Trimester of Pregnancy," Obstet Gynecol, 2005, 105(5 Pt 2):1173-6.
Byrnes JJ, Larcada A, and Moake JL, "Thrombosis Following Desmopressin for Uremic Bleeding," Am J Hematol, 1988, 28(1):63-5.
Cattaneo M, "Review of Clinical Experience of Desmopressin in Patients With Congenital and Acquired Bleeding Disorder," Eur J Anesthesiol Suppl, 1997, 14:10-4.
Cheetham T and Baylis PH, "Diabetes Insipidus in Children," Pediatr Drugs, 2002, 4(12):785-96.
Chistolini A, Dragoni F, Ferrari A, et al, "Intranasal DDAVP®: Biological and Clinical Evaluation in Mild Factor VIII Deficiency," Haemostasis, 1991, 21(5):273-7.
Couch P and Stumpf JL, "Management of Uremic Bleeding," Clin Pharm, 1990, 9(9):673-81.
Das P, Carcao M, and Hitzler J, "DDAVP-Induced Hyponatremia in Young Children," J Pediatr Hematol Oncol, 2005, 27(6):330-2.
Das P, Carcao M, and Hitzler J, "Use of Recombinant Factor VIIa Prior to Lumbar Puncture in Pediatric Patients With Acute Leukemia," Pediatr Blood Cancer, 2006, 47(2):206-9.
Dave SP, Greenstein AJ, Sachar DB, et al, "Bleeding Diathesis in Amyloidosis With Renal Insufficiency Associated With Crohn's Disease: Response to Desmopressin," Am J Gastroenterol, 2002, 97(1):187-9.
Eller N, Kollenz CJ, and Hitzenberger G, "A Comparative Study of Pharmacodynamics and Bioavailability of 2 Different Desmopressin Nasal Sprays," Int J Clin Pharmacol Ther, 1998, 36(3):139-45.
Eller N, Kollenz, Bauer P, et al, "The Duration of Antidiuretic Response of Two Desmopressin Nasal Sprays," Int J Clin Pharmacol Ther, 1998, 36(9):494-500.
Lusher JM, "Response to 1-Deamino-8-D-Arginine Vasopressin in von Willebrand Disease," Haemostasis, 1994, 24(5):276-84.
Mannucci PM and Cattaneo M, "Desmopressin: A Nontransfusional Treatment of Hemophilia and von Willebrand Disease," Haemostasis, 1992, 22(5)276-80.
Mannucci PM, Remuzzi G, Pusineri F, et al, "Deamino-8-D-Arginine Vasopressin Shortens the Bleeding Time in Uremia," N Engl J Med, 1983, 308(1):8-12.
Molnar Z, Farkas V, Nemes L, et al, "Hyponatraemic Seizures Resulting From Inadequate Post-Operative Fluid Intake Following a Single Dose of Desmopressin," Nephrol Dial Transplant, 2005, 20(10):2265-7.
Rembratt A, Graugaard-Jensen C, Senderovitz T, et al, "Pharmacokinetics and Pharmacodynamics of Desmopressin Administered Orally Versus Intravenously at Daytime Versus Night-Time in Healthy Men Aged 55-70 Years," Eur J Clin Pharmacol, 2004, 60(6):397-402.
Rembratt A, Riis A, and Norgaard JP, "Desmopressin Treatment in Nocturia; An Analysis of Risk Factors for Hyponatremia," Neurourol Urodyn, 2005, 25(2):105-9.
Richardson DW and Robinson AG, "Desmopressin," Ann Intern Med, 1985, 103(2):228-39.
Robson WL, Leung AK, and Norgaard JP, "The Comparative Safety of Oral Versus Intranasal Desmopressin for the Treatment of Children With Nocturnal Enuresis," J Urol, 2007, 178(1):24-30.
Smith TJ, Gill JC, Ambruso DR, et al, "Hyponatremia and Seizures in Young Children given DDAVP," Am J Hematol, 1989, 31(3):199-202.
Stenberg A and Läckgren G, "Desmopressin Tablets in the Treatment of Severe Nocturnal Enuresis in Adolescents," Pediatrics, 1994, 94(6 Pt 1):841-46.
Thumfart J, Roehr CC, Kapelari K, et al, "Desmopressin Associated Symptomatic Hyponatremic Hypervolemia in Children. Are There Predictive Factors?" J Urol, 2005, 174(1):294-8.
Watson AJ and Keogh JA., "1-Deamino-8-D-Arginine Vasopressin as a Therapy for the Bleeding Diathesis of Renal Failure," Am J Nephrol, 1984, 4(1):49-51.
Watson AJ and Keogh JA, "1-Deamino-8-d-Arginine Vasopressin (DDAVP): A Potential New Treatment for the Bleeding Diathesis of Acute Renal Failure," Pharmatherapeutica, 1984, 3(9):618-22.
Weinstein RE, Bona RD, Altman AJ, et al, "Severe Hyponatremia after Repeated Intravenous Administration of Desmopressin," Am J Hematol, 1989, 32(4):258-61.
International Brand Names
Lexi-Comp.com
Last full review/revision March 2012
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