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!!! Acetaminophen; Dextromethorphan; 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. DDAVP Dosage Guide - Drugs.com The necessity for repeat administration of DDAVP or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. Acetaminophen; 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. Accessibility 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. DDAVP/Desmopressin Injection - Summary of Product Characteristics (SmPC Cyclizine SC or IV Nausea and vomiting 0.5 1 14.5 0 Diamorphine$ SC or IV Pain 0.075 0.1 2.175 2.9 1.45 3.2625 Diazepam PR Agitation, convulsions 10 Hydrocortisone IV Anaphylaxis 2 4 58 116 Hyoscine hydrobromide SC or IV Respiratory tract secretions 0.01 0.01 0.29 0.29 Midazolam SC or IV Anxiety or agitation 0.06 0.1 1.74 2.9 2 4.5 Unauthorized use of these marks is strictly prohibited. Available for Android and iOS devices. Vincristine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. 1998 Nov;82(5):642-6 Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. <> Max IV rate (usual): 5 mg/min. Prepare the solution for infusion using aseptic technique. The pharmacokinetic profile of desmopressin is biexponential. 2022 Mar 8;7(1):e000852. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Chlorpropamide: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including chlorpropamide. Prednisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. administration route. A woman who took both desmopressin and ibuprofen was found in a comatose state. Adjust dose based upon response to treatment estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. Many persons with type 2 vWD do not respond to desmopressin and require alternate treatment; however, a desmopressin trial can help confirm diagnosis and may be useful in some instances of mild bleeding in persons with type 2 vWD. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin Stimulates Nitric Oxide Production in Human Lung Microvascular Endothelial Cells. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Lansoprazole; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The recommended dose for women is lower than for men because women are more sensitive to the effects of desmopressin sublingual tablet and had a higher risk of hyponatremia with the 55.3 mcg dose in clinical trials. <> Desmopressin (Injection Route) Proper Use - Mayo Clinic Preserve in tight containers, protected from light. If used preoperatively, administer 2 hours before surgery. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. PDF DDAVP Nasal Spray DESCRIPTION DDAVP - Food and Drug Administration 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. Decompensated Hypothyroidism ("Myxedema Coma") - EMCrit Project The time to reach maximum plasma desmopressin levels is 0.9 hours. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 0.3 mcg/kg/dose (Max: 20 mcg/dose) IV once. Metoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. 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. Drugs; . The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. Initiate fluid restriction during treatment with DDAVP Injection [see Warnings and Precautions (5.1), Use in Specific Populations (8.4, 8.5)]. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication.[42295]. Desmopressin is primarily excreted in the urine, with a significant portion excreted as unchanged drug (65% after oral and 92% after intranasal administration). Blood pressure and heart rate monitoring during infusion is recommended. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. celebrity wifi packages cost. Caution should be used when coadministering these agents. PDF Intravenous Medication Guidelines for Adults - VCHCA Further hospitalization cost saving may be achieved through reduced Promethazine; 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. 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. 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 FOIA 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. It acts on the kidneys to reduce the flow of urine. A woman who took both desmopressin and ibuprofen was found in a comatose state. Children younger than 12 years of ageUse and dose must be determined by your doctor. Consider risk vs. benefit as pregnant women with Hemophilia A or von Willebrand's disease as these patients may be at an increased risk for bleeding diatheses and hemorrhagic events at delivery; affected neonates may also be at risk of bleeding diatheses. once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. May repeat dose if needed. At two hours after . Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Intranasal: 5 to 40 mcg/day divided into 1 to 3 doses. Do not transfer any remaining solution to another bottle. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Famotidine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The mean (+/- S.D.) Once the dose is in the tube, hold the tube with your fingers, about 3/4 inch from the end.Put the tube into a nostril, until your fingers touch the nostril. Heparin: (Minor) Desmopressin has been shown to have an additive effect on the anticoagulant activity of heparin. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin acetate 100 microgram Tablet - medicines Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Intranasal: Controls bleeding in certain types of hemophilia and von Willebrand's disease Pharmacokinetic parameters were derived using a two-compartmental model except for AUC(0-->t), which was derived using non-compartmental analysis. Missed Dose The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. hydromorphone dose conversion. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. IV: 0.3 mcg/kg once slowly over 15-30 minutes. IV: 0.3 mcg/kg once slowly over 15 to 30 minutes. Oral to IV conversion (approximate): oral dose x 0.625 = daily IV dose.. HYDROCORTISONE (SOLU CORTEF) 0 to 100mg/ 100 ml 101 to 150 mg/ 150. minlinklosubs - Hydrocortisone iv to po steroid dosing conversion. See Table 1 for volume of diluent to use. The tendency toward tachyphylaxis (lessening of response) with repeated administration given more frequently than every 48 hours should be considered in treating each patient. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Hydrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. [33605], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive 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. 4. Repeat administration should be determined by laboratory response and clinical condition of the patient. Antidiuretic effects usually occur within 15 to 60 minutes, with peak effects evident 1 to 5 hours after nasal administration. Use careful attention to fluid management to avoid hyponatremia in the peripartum and postpartum period and weigh the possible therapeutic advantages against the possible risks in each individual case. September, 2004 Hospira 2004 EN-0511 Printed in USA HOSPIRA, INC., LAKE FOREST, IL 60045 USA. PATIENTS NOT AT INCREASED RISK FOR HYPONATREMIA: 1 spray (1.66 mcg) in either the left or right nostril approximately 30 minutes before going to bed. Quinapril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Guidelines recommend administering no more than once every 24 hours or for more than 3 consecutive days to minimize risk of hyponatremia and seizures. 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. IV: 0.3 mcg/kg once slowly over 15-30 minutes. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. A desmopressin response requires an increase of at least 2 times the baseline von Willebrand factor (vWF) activity and an increase of both vWF and factor VIII concentrations of more than 0.5 International Units/mL for at least 4 hours. 2 0 obj Careful fluid intake restrictions are required in pediatric patients to prevent hyponatremia and water intoxication. Amlodipine; Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin (DDAVP) in the Treatment of Bleeding Disorders: The First Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. A woman who took both desmopressin and ibuprofen was found in a comatose state. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Oxybutynin: (Major) Hyponatremia-induced convulsions have been rarely reported when oxybutynin and desmopressin are used concomitantly. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Objective: Olmesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Following oral administration, the onset of antidiuretic effect occurs around 1 hour and reaches a maximum at 4 to 7 hours. Background. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Increased Factor VIII activity is noted 30 minutes after IV administration, with peak activity occurring in 90 minutes to 2 hours. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Desmopressin - UpToDate 27.7 mcg sublingually once daily, 1 hour before bedtime without water. 3 0 obj Effect of acute desmopressin and of long-term thyroxine replacement on haemostasis in hypothyroidism. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. Pharmacologic: antidiuretic hormones + + + Indications + + PO, SC, IV, Intranasal: Treatment of diabetes insipidus caused by a deficiency of vasopressin. Thiazide diuretics: (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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Factors associated with mortality of myxedema coma: report of eight cases and literature survey. 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. The frequency of dosing varies with patient responses. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. A woman who took both desmopressin and ibuprofen was found in a comatose state. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. endobj eCollection 2022. *Ovv]pu}gz$3 June 30, 2022 by . Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 0.2 to 0.6 mg orally once daily before bedtime. 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. Benazepril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. DOSAGE AND ADMINISTRATION Hemophilia A and von Willebrand's Disease (Type I): Desmopressin Acetate Injection 4 mcg/mL is administered as an intravenous infusion at a dose of 0.3 mcg desmopressin acetate/kg body weight diluted in sterile physiological saline and infused slowly over 15 to 30 minutes. Desmopressin (dDAVP), a synthetic analogue of 8-arginine vasopressin (ADH), is an antidiuretic . IV infusion IV Infusion IV Infusion (OB) Only REGULAR insulin may be administered by the IV route. <> Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Drug class: Antidiuretic hormones. Severe allergic reactions, including anaphylaxis, have been reported with intravenous and intranasal desmopressin.
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