Drugs; . The distribution of the drug is unknown, and it is not clear whether desmopressin crosses the placenta. Bendroflumethiazide; Nadolol: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Desmopressin acetate 200 microgram tablets; 10microgram/mL WCHN prepared solution; 4microgram/mL injection solution - SA Neonatal Medication Guidelines | SA Health Medication guideline for the management of neonates requiring desmopressin acetate. Adjust treatment according to the diurnal pattern of response. R8cxz. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Then i-Vents acuity will now have a 10 to signify there is a open i-Vent. eCollection 2022. 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. Dopamine: (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 dopamine only with careful patient monitoring. 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. Enalapril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Maximal dose-response increase in Factor VIII activity occurs at 0.3 to 0.4 mcg/kg desmopressin. Store refrigerated 2 to 8C (36 to 46F). -, BJU Int. 2005 Oct;27(5):655-65. doi: 10.1097/01.ftd.0000168293.48226.57. sharing sensitive information, make sure youre on a federal 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. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. doi: 10.31744/einstein_journal/2023RC0124. For desmopressin Desmopressin is an analogue of vasopressin. Oral: 0.05 mg twice a day. Dosage: (For neonatal dosages, refer to Neonatal IV Drug Manual.) Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 1 to 2 mcg IV twice a day or Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. Of course, hypertonic bicarbonate could also be used, as discussed last week. Dexamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. You can adjust the side column for all the news articles in the 'side column' tab above 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. Oral doses of 0.2 and 0.4 mg produce similar responses on urine volume and urine osmolality as 0.01 mg and 0.02 mg intranasal doses. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Preoperative doses may be given 2 hours prior to the scheduled procedure. IV: 0.3 mcg/kg once slowly over 15-30 minutes. 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. In certain clinical situations, it may be justified to try DDAVP in patients with factor VIII levels between 2% to 5%; however, these patients should be carefully monitored. 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. Deflazacort: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 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. Tachyphylaxis (lessening of response) with repeated administration (i.e., given more frequently than every 48 hours) may occur. Federal government websites often end in .gov or .mil. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Monitor patients for signs or symptoms of hypersensitivity reactions during administration, interrupt treatment should a reaction occur, and manage medically. Initially, 0.05 mg PO twice daily, then titrate to response. WBC count of 3,000mm 3. 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. 1997;183:53-4. Repeat dosing is not recommended due to tachyphylaxis. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diclofenac; Misoprostol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). Trauma Surg Acute Care Open. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia, which may include monitoring serum sodium or electrolytes periodically. Torsemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. Decrease bleeding following cardiac bypass: 0.3 mcg/kg ivpb. Medication guideline for the management of neonates requiring desmopressin acetate. Acetaminophen; 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. 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. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Intravenous desmopressin should be considered when indicated. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Rotoli BM, Visigalli R, Ferrari F, Ranieri M, Tamma G, Dall'Asta V, Barilli A. Biomolecules. A woman who took both desmopressin and ibuprofen was found in a comatose state. Fluticasone; Salmeterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. IV and subcutaneously: No definitive dosing available. A woman who took both desmopressin and ibuprofen was found in a comatose state. <> 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication.[42295]. Do not transfer any remaining solution to another bottle. Following administration of intranasal desmopressin for nocturia, the median time to peak plasma concentrations (Tmax) was 0.25 hour for the 0.83 mcg dose and 0.75 hour for the 1.66 mcg dose. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. Ensure the serum sodium concentration is within normal limits prior to starting or resuming desmopressin therapy. Determine need for repeat dosage based on laboratory response and patient's clinical condition. 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. Use desmopressin nasal spray for nocturia with caution and monitoring of blood volume status in persons with New York Heart Association Class I congestive heart failure. A comparison was made of intranasal administration of 300 micrograms desmopressin (DDAVP) by spray, with intravenous administration of 0.2, 0.3 and 0.4 microgram DDAVP/kg in 10 healthy volunteers. Methods: The study had an open, randomised, four-way cross-over design. Meclofenamate Sodium: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. DrugBank Accession Number. Bioavailability and pharmacokinetics of desmopressin in elderly men. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. In the elderly, careful fluid intake restrictions are required to prevent hyponatremia and water intoxication. 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. Put the other end of the tube into the patients mouth; the patient should hold their breath.Tilt the patient's head back and have them blow with a short strong puff through the tube. 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. Dose range is 5 to 30 mcg/day. Repeat administration should be determined by laboratory response and clinical condition of the patient. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. During initial titration and continued therapy, observe and monitor closely; adjust treatment to the diurnal pattern of response. Infusion Pump Required. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. 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. 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. 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. Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. A woman who took both desmopressin and ibuprofen was found in a comatose state. Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 1. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses. 1999 Dec;84 Suppl 1:5-8 Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral 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. The bioavailability was 0.08%. The volume of diluent is weight-based. DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. Two children with diabetes insipidus had decreasing desmopressin requirements with lamotrigine initiation. Adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. (Synthetic analog of vasopressin-posterior pituitary hormone). Dependent on route of administration and indication for therapy. The necessity for repeat administration of desmopressin acetate or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. Hydrochlorothiazide, HCTZ; Methyldopa: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Objective: Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 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. dose conversion. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. how do you switch from labetalol IV to PO. Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. Following oral administration, the bioavailability of desmopressin is about 5% and 0.16% compared to intranasal and intravenous administration, respectively. To prime, press down 4 times. Metolazone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Infants 3 months of age to children 12 years of age: Triamterene; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with 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. 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. Levels of FVIII are also increased, which increases hemostasis by accelerating fibrin formation. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. If there are dry nights after Desmopressin is used, continue using it for 3 months and then review your child's progress. 2 0 obj Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Furosemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Medically reviewed by Drugs.com. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL 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. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. 8-10 mg IV = 40 mg PO. *L#n~i V3{kf_t.wjO_KgImL%4+GJ+Pp QsWAd._e7p!90&z {c`Kk;swZ/Nf{s~d? Pharmacokinetic parameters were derived using a two-compartmental model except for AUC(0-->t), which was derived using non-compartmental analysis. 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. 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. Objective: To investigate (1) the pharmacokinetic and pharmacodynamic profiles of desmopressin in men from an age group with a high incidence of nocturia; and (2) circadian variation in the pharmacokinetic parameters. DDAVP is also available as nasal spray and tablet dosage forms. Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. endobj Intranasal: Controls bleeding in certain types of hemophilia and von Willebrand's disease Tilt bottle so that the tube inside the bottle draws from the deepest portion of the medication.If given preoperatively, intranasal desmopressin should be administered 2 hours before surgery.To avoid the spread of infection, do not use the container for more than 1 person.Discard spray pump after 25 sprays since the amount delivered thereafter per spray may be substantially less than the recommended dose. Baseline renal function should be assessed. The frequency of dosing varies with patient responses. Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. 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. Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. It is chemically defined as follows: Mol. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Every 3 months, The usual dosage range in adults is 0.5 mL (2 mcg) to 1 mL (4 mcg) daily, administered intravenously or subcutaneously, usually in two divided doses. Do Not Copy, Distribute or otherwise Disseminate without express permission. Fifteen healthy men aged 55-70 years were included in the analysis. 2 0 obj 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.
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