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Desmopressin (Nasal route)

Pronunciation:

des-moe-PRES-in

Brand Names:

  • DDAVP
  • DDAVP Rhinal Tube
  • Minirin
  • Stimate

Dosage Forms:

  • Solution
  • Spray

Classifications:

Therapeutic—

Endocrine-Metabolic Agent

Pharmacologic—

Vasopressin (class)

Uses of This Medicine:

Desmopressin nasal spray is used to treat central cranial diabetes insipidus. This is a condition that causes the body to lose too much fluid and become dehydrated. It is also used to control frequent urination and increased thirst caused by certain types of brain injury or brain surgery. The Stimate® nasal spray is used to treat bleeding in patients with hemophilia A or von Willebrand disease (Type I).

Desmopressin is similar to a hormone that is produced in the body. It acts on the kidneys to reduce the flow of urine. For bleeding, desmopressin increases the blood levels of factor VIII and von Willebrand factor. This results in less bleeding for patients who have low levels of these agents.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of desmopressin nasal spray for diabetes insipidus in children 3 months of age and older.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of Stimate® to treat hemophilia A and von Willebrand disease in children 11 months of age and older. However, use is not recommended in children younger than 11 months of age.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of desmopressin nasal spray in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving desmopressin.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood clotting problems or
  • Hypertension (high blood pressure) or
  • Hypotension (low blood pressure) or
  • Tachycardia (increased heart rate)—Use with caution. May make these conditions worse.
  • Coronary artery disease or
  • Cystic fibrosis or
  • Heart failure or
  • Kidney problems or
  • Polydipsia (excessive thirst), habitual or psychogenic—Use with caution. May cause side effects to become worse.
  • Hyponatremia (low sodium in the blood), or history of or
  • Kidney disease, moderate to severe—Should not be used in patients with these conditions.
  • Type IIB von Willebrand disease—Stimate® should not be used in patients with this condition.

Proper Use of This Medicine:

Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

This medicine should only be used in the nose.

Your doctor may limit the amount of fluid or water you drink. Follow the instructions carefully to prevent unwanted effects.

To use the nasal spray:

  • When used for the first time, the spray must be primed. Press the pump down 4 times. If the spray is not used for 1 week, prime the pump again by pressing once.
  • Gently blow your nose before using the spray. Tilt your head back slightly and insert the tip of the nose piece into your nostril.
  • Close the opposite nostril with a finger. Release one spray and breathe in gently at the same time.
  • Hold your breath for a few seconds then breathe out slowly through the mouth.
  • If a second dose is needed, spray the opposite nostril using the same steps.
  • Do not blow your nose or tip your head back after using the spray.
  • Wipe the tip of the bottle with a clean, dry tissue and replace the cap.
  • Throw away any unused medicine after 25 sprays (Stimate®) or 50 sprays (DDAVP® or desmopressin generic).

To use the DDAVP® Rhinal Tube nasal system:

  • The rhinal tube applicator is a soft, flexible plastic tube with numbers printed on the side. The numbers represent the dose.
  • Place the correct amount of medicine in the tube by inserting the tip of the container in the end of the tube that is marked with an arrow.
  • Put the end of the tube that is marked with an arrow into one nostril and put the other end into your mouth.
  • Hold your breath, tilt the head back, and blow with a short, strong puff until all the medicine is sprayed into the nose.
  • Do not let medicine run into your throat.
  • For young children, an adult must blow the medicine into the nose.
  • Wash the tube with water and shake it to remove all of the water.
  • Put the seal back on the container tip and replace the plastic cap.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For nasal dosage form (nasal spray):
    • For treatment of diabetes insipidus:
      • Adults and teenagers—0.1 to 0.4 milliliter (mL) given as a single dose or divided into 2 or 3 doses per day. The dose is given in one nostril or divided and given in both nostrils. Your doctor may adjust the dose as needed.
      • Children 3 months to 12 years of age—0.05 to 0.3 mL given as a single dose or divided into 2 doses per day. The dose is given in one nostril or divided and given in both nostrils. Your doctor may adjust the dose as needed.
      • Children younger than 3 months of age—Use and dose must be determined by your doctor.
    • For treatment of hemophilia A or won Willebrand disease:
      • Adults and teenagers—One spray (0.1 milliliter) in each nostril as a single dose per day. Your doctor may adjust the dose as needed.
      • Children 11 months to 12 years of age—Use and dose must be determined by your doctor.
      • Children younger than 11 months of age—Use is not recommended.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

DDAVP® or desmopressin generic: Store at room temperature in an upright position.

DDAVP® Rhinal Tube System: Store in the refrigerator in an upright position. For travelers, the product is good for up to 3 weeks at room temperature.

Stimate®: Store at room temperature in an upright position. Throw bottle away 6 months after it is used for the first time.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it. Blood and urine tests may be needed to check for unwanted effects.

This medicine lowers the amount of sodium in your blood. Check with your doctor right away if you have confusion, nausea, vomiting, muscle cramps or spasms, or unusual tiredness or weakness.

Desmopressin may rarely cause severe allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, swelling of the face, tongue, and throat, trouble breathing, or chest pain after you use this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
Chills
confusion
convulsions
cough
difficulty swallowing
dizziness
drowsiness
fever
puffiness or swelling of the eyelids or around the eyes
skin rash, hives, or itching
tightness in the chest
trouble breathing
unusual tiredness or weakness
Incidence not known
Chest pain
decreased urine output
fast, irregular, pounding, or racing heartbeat or pulse
headache
increased thirst
muscle pain or cramps
nausea or vomiting
swelling of the face, ankles, or hands

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Runny or stuffy nose
sneezing
Less common
Bloody nose
burning, dry, or itching eyes
diarrhea
eye discharge or excessive tearing
indigestion
loss of appetite
passing gas
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
stomach pain, fullness, or discomfort
Incidence not known
Abdominal or stomach cramps
acid or sour stomach
belching
feeling of warmth
headache
heartburn
redness of the face, neck, arms, and upper chest
sleepiness or unusual drowsiness
trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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