Desmopressin - Instructions For Use, Indications, Doses, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Desmopressin

Instructions for use:

1. 1. Release form and composition
2. 2. Indications for use
3. 3. Contraindications
4. 4. Method of application and dosage
5. 5. Side effects
6. 6. Special instructions
7. 7. Drug interactions
8. 8. Analogs
9. 9. Terms and conditions of storage
10. 10. Terms of dispensing from pharmacies

Prices in online pharmacies:

from 1277 rub.

Buy

Desmopressin is a drug with a pronounced antidiuretic effect, an analogue of vasopressin.

Release form and composition

Dosage forms:

• tablets: round, white, on one side there is an engraving "D1" or "D2", on the other - a dividing line (28, 30 or 90 pieces in a polyethylene container, in a cardboard box 1 container; in a blister strip: each 10 pcs., In a carton box 1, 2, 3, 4, 5, 6 or 10 packs, 30 pcs., In a carton box 1, 2, 3, 4, 5, 6, 8 or 10 packs; 10, 20, 30, 40, 50 or 100 pcs. In a polyethylene terephthalate jar, in a cardboard box 1 can);
• dosed nasal spray: colorless liquid with a transparent structure (50 doses in a glass bottle of dark color with a dosing device, 1 bottle in a cardboard box);
• nasal drops: colorless transparent liquid (5 ml in a dropper bottle, 1 dropper bottle in a cardboard box).

1 tablet contains:

• active substance: desmopressin acetate - 0.1 mg or 0.2 mg, which corresponds to 0.089 mg or 0.178 mg of desmopressin;
• auxiliary components: lactose monohydrate, povidone-K30, potato starch, magnesium stearate.

1 ml of spray contains:

• active substance: desmopressin acetate - 0.1 mg, which corresponds to 0.089 mg of desmopressin;
• auxiliary components: potassium sorbate, sodium chloride, hydrochloric acid (pH 4.7), purified water.

1 ml drops contain:

• active substance: desmopressin - 0.1 mg;
• auxiliary components: chlorobutanol, sodium chloride, hydrochloric acid (pH 3.2–4.5), purified water.

Indications for use

The use of Desmopressin is indicated for the diagnosis and treatment of central diabetes insipidus.

In addition, separate indications for dosage forms:

• tablets: children over 5 years old - primary nocturnal enuresis; adults - symptomatic therapy of nocturnal polyuria;
• dosed nasal spray and nasal drops: diagnostic test for the concentration ability of the kidneys;
• nasal drops: acute polyuria of central genesis, caused by a disease or surgery on the central nervous system, trauma.

Contraindications

• syndrome of inadequate production of antidiuretic hormone;
• pathologies requiring the use of diuretics;
• congenital or psychogenic polydipsia;
• hyponatremia (including history);
• hypersensitivity to drug components.

In addition, there are separate contraindications for each of the forms:

• tablets: moderate and severe renal failure [creatinine clearance (CC) less than 50 ml / min], chronic heart failure, lactase deficiency, lactose or fructose intolerance, glucose-galactose malabsorption syndrome;
• spray and drops: impaired consciousness, plasma hypoosmolarity, decompensated heart failure (including history), allergic rhinitis, edema and scarring of the nasal mucosa, nasal congestion, upper respiratory tract infections;
• drops: edematous syndrome of various etiologies, anuria, moderate and severe renal failure (CC less than 50 ml / min), predisposition to thrombosis.

Desmopressin should be prescribed with caution in patients with renal failure, bladder fibrosis, imbalance in water and electrolyte balance, potential risk of increased intracranial pressure, elderly age (over 65 years), during pregnancy and lactation.

In addition, you should be careful:

• tablets: bronchial asthma, diseases of the cardiovascular system, epilepsy, migraine (including anamnesis);
• spray: up to 1 year old;
• drops: age up to 5 years.

Method of administration and dosage

Pills

The tablets are taken orally, some time after meals.

Recommended dosage:

• central diabetes insipidus: the initial dose is 0.1 mg 1-3 times a day for children and adults. Further, the dose is selected taking into account the individual clinical response, it can range from 0.2 mg to 1.2 mg per day;
• primary nocturnal enuresis: the initial dose is 0.2 mg before bedtime; in the absence of a sufficient therapeutic effect, it can be increased to 0.4 mg. It is necessary to limit fluid intake in the evening. Course duration is 90 days. After a 7-day break, pills can be resumed based on clinical indications;
• nocturnal polyuria in adults: the initial dose is 0.1 mg before bedtime, in the absence of the required effect, it is increased every 7 days by 0.1 mg until the dose that provides the optimal effect is reached.

In the absence of an adequate clinical response after 30 days of treatment, the drug should be discontinued.

Dosed nasal spray

The spray is applied by intranasal administration, one press on the dosing device corresponds to 0.01 mg of the drug.

When treating children, the procedure should be carried out under the supervision of an adult.

The optimal dose is determined by individual selection.

Recommended dosage:

• central diabetes insipidus: adults - 0.01-0.04 mg, children - 0.01-0.02 mg per day. The procedure is carried out once or the prescribed dose is divided into 2–3 injections;
• kidney concentration test: adults - 0.04 mg, children over 1 year old - 0.01–0.02 mg, children under 1 year old - 0.01 mg. After the introduction, the patient must empty the bladder, during the next 8 hours, 2 portions of urine are taken to study its osmolality. The total volume of liquid drunk by the patient during the test (1 hour before the study and during the next 8 hours) should not exceed 500 ml. If an osmolality indicator is found below 800 mOsm / kg in adults and 600 mOsm / kg in children, the test is repeated. If a violation of the concentration ability of the kidneys is confirmed, additional examinations are required.

Nasal drops

Drops are used intranasally, by instillation into the nasal passage towards the nasal septum with a slight tilt of the head back and tilting it to the side.

The manifestation of a therapeutic effect occurs within 30 minutes after instillation of the drug.

Recommended dosage:

• diabetes insipidus of central origin: adults - 0.01–0.04 mg (2–8 drops), children - 0.005–0.02 mg (1–4 drops) per day. The drug is administered once, or the daily dose is divided into 2-3 injections. The doctor prescribes the dose and the interval between injections individually, taking into account the patient's sensitivity to the drug;
• acute form of central polyuria: 0.01 mg each. Diuresis and fluid intake should be assessed at hourly intervals until full balance is achieved. Within 3-5 hours, observe the osmolarity of plasma and urine, the concentration of sodium in the blood;
• study of the concentration ability of the kidneys: adults - 0.015 mg, children over 1 year old - 0.01–0.015 mg. After instillation of the drug, emptying of the bladder is required. Then collect urine samples to determine osmolarity, the procedure is repeated 4 times with an interval of 1 hour. If thirst arises, it is allowed to take no more than 200 ml of liquid for the entire period (1 hour before the study and during the next 8 hours) of the study.

Side effects

Against the background of the use of all forms of Desmopressin, nausea, dizziness, headache may appear, and in case of violation of the regime that restricts fluid intake, fluid retention occurs in the body, which is accompanied by edema, the development of hyponatremia, increased body weight, and generalized convulsions.

In addition, desmopressin causes side effects that are characteristic of certain forms:

• tablets: dry mouth, vomiting, hot flashes, hyperemia of the sclera, transient tachyarrhythmia;
• dosed nasal spray and nasal drops: possibly - abdominal pain; swelling of the nasal mucosa or runny nose, nosebleeds, rhinitis; rarely - allergic reactions; in isolated cases - decreased lacrimation, conjunctivitis;
• nasal drops: in isolated cases - algodismenorrhea, increased blood pressure.

special instructions

Desmopressin should not be used in patients with concomitant pathologies or while taking drugs that can cause fluid retention in the body and electrolyte disorders.

Patients with primary nocturnal enuresis 1 hour before and within 8 hours after using the drug should reduce fluid intake as much as possible - this will reduce the risk of side effects.

The use of Desmopressin for the treatment of nocturnal enuresis in children and young patients is at risk of developing cerebral edema.

Patients with polyuria (2.8 to 3 L) and low baseline sodium levels are at high risk for side effects.

It is recommended to use the drug with extreme caution in patients over 65 years of age due to the high risk of fluid retention, the development of hyponatremia and other adverse events. The patient should be monitored and regularly (before the start of treatment, after three days of therapy and at each dose increase) determination of the level of sodium concentration in the blood plasma.

If fever, systemic infections or gastroenteritis occur, the drug should be discontinued.

For the prevention of hyponatremia, frequent studies are recommended to determine the level of sodium in the blood plasma, especially when combining tablets with tricyclic antidepressants, selective serotonin inhibitors, chlorpromazine, carbamazepine, other drugs that cause the syndrome of inadequate secretion of antidiuretic hormone, and in combination with non-steroidal anti-inflammatory drugs (NSAIDs).

Diagnosis and treatment of acute urinary incontinence, nocturia and / or dysuria, urinary tract infections, tumors of the bladder or prostate gland, decompensated diabetes mellitus, polydipsia, alcoholism should be carried out prior to the use of Desmopressin.

In children under 1 year of age, the kidney concentration test should be performed only in a hospital setting.

After conducting diagnostic studies, the patient is allowed to take fluid in a volume that quenches his thirst.

Dosed spray should not be prescribed to children if the dose required for therapy is below 0.01 mg.

The study of the concentration ability of the kidneys using drops in children under 1 year old should be carried out in exceptional cases, since at this age the concentration ability of the kidneys is reduced. The procedure should be performed by a pediatric neurologist. Too high a dose in infants can irritate the nervous system, which is accompanied by the development of seizures. During the period of urine collection, complete elimination of fluid intake is required.

Since with severe rhinitis, the absorption of drops is impaired, it is recommended to use the drug inside.

In central diabetes insipidus, intranasal use of desmopressin increases the risk of severe hyponatremia.

Drug interactions

With the simultaneous use of Desmopressin:

• indomethacin can increase the effect of desmopressin without increasing its duration;
• tetracycline, glibutide, norepinephrine, lithium preparations reduce the antidiuretic effect of the drug;
• hypertensive drugs enhance their effect;
• selective serotonin inhibitors, tricyclic antidepressants, carbamazepine, chlorpromazine can cause a syndrome of inappropriate antidiuretic hormone secretion, an increase in the antidiuretic effect of desmopressin, an increased risk of fluid retention and the development of hyponatremia;
• NSAIDs increase the risk of fluid retention in the body, the occurrence of hyponatremia;
• dimethicone reduces drug absorption;
• Loperamide and other peristalsis-inhibiting drugs can triple plasma desmopressin levels and significantly increase the risk of fluid retention and hyponatremia.

Analogs

Desmopressin analogs are: tablets - Minirin, Nativa, Nurem, spray - Apo-Desmopressin, Presynex, Minirin, Vazomirin.

Terms and conditions of storage

Keep out of the reach of children.

Store at temperature: tablets - up to 30 ° C, nasal dosed spray - up to 25 ° C, nasal drops (in a dry, dark place) - 2-8 ° C.

Shelf life: tablets - 2.5 years, nasal dosed spray and nasal drops - 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Desmopressin: prices in online pharmacies

Drug name Price Pharmacy

Desmopressin 0.1 mg tablets 30 pcs. 1277 RUB Buy

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!