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A woman who took both desmopressin and ibuprofen was found in a comatose state. If doses other than these are required, the rhinal tube delivery system may be used.One spray (10 mcg) has an antidiuretic activity of about 40 International Units.The nasal spray must be primed prior to first use. Do not transfer any remaining solution to another bottle. The site is secure. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. IV infusion . Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral desmopressin). Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Guidelines recommend administering no more than once every 24 hours or for more than 3 consecutive days to minimize risk of hyponatremia and seizures. [33605], Initially, 10 mcg (0.1 mL) intranasally into 1 nostril, may increase to 30 mcg until the patient can sleep for an adequate period of time without incidence of polyuria. Conversion of IV Midazolam. IV infusion IV Infusion IV Infusion (OB) Only REGULAR insulin may be administered by the IV route. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. *L#n~i V3{kf_t.wjO_KgImL%4+GJ+Pp QsWAd._e7p!90&z {c`Kk;swZ/Nf{s~d? The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Sumatriptan; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. 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: Dosing, contraindications, side effects, and pill - Epocrates Bethesda, MD 20894, Web Policies Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. May repeat dose after 8 to 12 hours and once daily thereafter as needed to reduce spontaneous or traumatic bleeding. If used to reduce spontaneous or traumatic bleeding, doses may be repeated after 8 hours to 12 hours and once daily thereafter, if needed, based upon clinical condition and von Willebrand factor and factor VIII levels. Desmopressin is administered orally, intranasally, or parenterally (intravenous or subcutaneously). Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. DDAVP Dosage Guide - Drugs.com A woman who took both desmopressin and ibuprofen was found in a comatose state. These highlights do not include all the information needed to use DDAVP Child 2-11 years A woman who took both desmopressin and ibuprofen was found in a comatose state. When switching from DDAVP Tablets to DDAVP Injection, titrate dose individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) due to the large variability in both PK and PD. 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. Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Azelastine; Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. Dosage: (For neonatal dosages, refer to Neonatal IV Drug Manual.) 0.3 mcg/kg/dose (Max: 20 mcg/dose) IV once. Desmopressin nasal sprays may not be substituted for each other due to significant differences in concentration. Acetaminophen; 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. Thiazide diuretics: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 2022 Mar 2;12(3):389. doi: 10.3390/biom12030389. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Telmisartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 1 0 obj Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Aminophylline IV Push IV Push IV Push IV Push IV bolus infuse over 20 -30 minutes not to exceed 25 mg/min; max concentration 25 mg/ml. Select one or more newsletters to continue. Blood pressure and heart rate monitoring during infusion is recommended. Preoperative doses may be given 2 hours prior to the scheduled procedure. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Taking control of severe hyponatremia with DDAVP - EMCrit Project Hougaard C, Matthiesen TB, Rittig S, Djurhuus JC. The pump will stay primed for up to 1 week. PDF Intravenous to Oral Therapy Conversion - FormWeb endobj Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. For the treatment of hypothyroidism of any etiology, except during the recovery phase of subacute thyroiditis; used as a replacement in primary (thyroidal), secondary (pituitary), tertiary (hypothalamic), congenital (cretinism), or acquired hypothyroidism. 55.3mcg of desmopressin acetate (equivalent to 50 mcg of desmopressin) Diabetes Insipidus Intranasal (DDAVP) Indicated as antidiuretic replacement therapy in the management of central cranial. Chlorthalidone: (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. 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. Desmopressin Acetate Injection, USPFor Intravenous or - DailyMed Cisplatin: (Moderate) Frequently monitor serum sodium levels if concurrent use of desmopressin and cisplatin is necessary. Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or enteral nutrition and/or receiving oral medications Infection does not require IV antibiotics Afebrile (< 100.4F in the last 24 hours) Received 24 hours of IV antibiotics Generic Name. 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. Nabumetone: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL How can you convert an orally administered dose to intraperitoneal 1995 Apr;42(4):373-8. doi: 10.1111/j.1365-2265.1995.tb02645.x [ PubMed ] 10646654 Yamamoto T, Fukuyama J, Fujiyoshi A. Idiopathic partial central diabetes insipidus. It is chemically defined as follows: Mol. The resultant increases in FVIII and vWF are similar to those seen with replacement therapy using blood products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Consider other treatment options for this condition. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended. May repeat dose if needed. In hemophilia A and von Willebrand disease, it should only be used for mild to moderate cases. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication. Flurbiprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Caution should be used when coadministering these agents. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. A woman who took both desmopressin and ibuprofen was found in a comatose state. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Dose should be reduced. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. Dose: 0.1-1.2 mg/day PO divided bid-tid; Start: 0.05 mg PO bid; Max: 1.2 mg/day; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; restrict fluid intake [parenteral route] Dose: 2-4 mcg/day SC/IV divided qd-bid; Info: parenteral dose is approx. Available for Android and iOS devices. 1999 Dec;84 Suppl 1:5-8 Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. This medication helps to control increased thirst and too much urination due to these conditions . 4. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia, which may include monitoring serum sodium or electrolytes periodically. Baseline renal function should be assessed. Bioavailability and pharmacokinetics of desmopressin in elderly men. Monitor serum sodium concentrations within 1 week and then approximately 1 month after treatment initiation and periodically thereafter. 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. Carbetapentane; 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. 0.02 mg IN, 0.2 mg PO and 0.4 mg PO) have a similar, pronounced pharmacodynamic effect on urine volume and urine osmolality. Pharmacokinetics and pharmacodynamics of desmopressin administered [61810], 2 to 4 mcg IV or subcutaneously given in 1 to 2 divided doses daily. Furosemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Desmopressin | Davis's Drug Guide for Rehabilitation Professionals | F According to the Beers Criteria, desmopressin is considered a potentially inappropriate medication (PIM) in geriatric adults and avoidance is recommended for treating nocturia or nocturnal polyuria because there is a high risk of hyponatremia and safer alternatives are available. All Rights Reserved. Adjust doses based on patient's diurnal pattern of response. Desmopressin works by limiting the amount of water passed in the urine. For desmopressin Desmopressin is an analogue of vasopressin. Administration of intranasal desmopressin may be compromised by nasal mucosa changes (e.g., nasal trauma, nasal surgery, nasal blockage, nasal mucosal atrophy, congestion, or severe atrophic rhinitis), cranial surgery, and nasal packing. The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. PMC When administered to patients with central diabetes insipidus, desmopressin exerts antidiuretic effects similar to those of vasopressin; a reduction in urine output with an accompanying increase in urine osmolality and a decrease in clinical symptoms of urinary frequency and nocturia are noted following desmopressin treatment. 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. Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude the presence of factor VIII autoantibodies. 50 kg or less: 150 mcg Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task. Oral TabletsIf converting from intranasal therapy, administer oral dose 12 hours after last intranasal dose.Patient response to each dose should be determined by adequate duration of sleep and adequate, not excessive, water turnover. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Dosing: Diabetes Insipidus Avoid spraying in the eyes. Desmopressin is contraindicated in persons with hyponatremia or a history of hyponatremia, polydipsia, concomitant loop diuretic or systemic or inhaled corticosteroid therapy, known or suspected syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and other illnesses that can cause fluid and electrolyte imbalance, such as gastroenteritis, salt-wasting nephropathies, or systemic infection. Drug class: Antidiuretic hormones. 1. An official website of the United States government. DDAVP Injection (desmopressin acetate) dose, indications, adverse - PDR In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. Desmopressin acetate injection 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 is in a class of medications called hormones. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 2023 Feb 10;21:eRC0124. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. PDF Intravenous Medication Guidelines for Adults - Ventura County, California DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. PDF Last Approval Date: Policy Title: Pharmacist-Managed Intravenous to If there is no response, the medication will be stopped. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fenoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. A Resource To Help With Changing From IV To PO Antibiotics 2005 Oct;27(5):655-65. doi: 10.1097/01.ftd.0000168293.48226.57. Prilocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Pharmacokinetics and pharmacodynamics in clinical use of scopolamine. Response should be estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Two children with diabetes insipidus had decreasing desmopressin requirements with lamotrigine initiation. Desmopressin: MedlinePlus Drug Information stream Ibuprofen: (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. Atenolol; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Desmopressin systemic 0.1 mg (232 0.1 barr). Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. endobj PDF IV to PO Conversion of Medications: Associated cost savings and reduced %f2fDWBRex1*s GZhlNx;hI>l!dKc:cmEg2&M*?*q$|sa[`ov#1q=[`0GP/==g5>dof?N~;1Y Less vasopressor activity. Usual dilution: 0.1 mcg/mL. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. Oral: 0.05 mg twice daily. If there are dry nights after Desmopressin is used, continue using it for 3 months and then review your child's progress. Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Plasminogen activator activity increases after intravenous desmopressin, but clinically significant fibrinolysis has not been detected in patients treated with desmopressin. Direct intravenous injectionNo dilution necessary.Inject IV over 1 minute. 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. Desmopressin (dDAVP), a synthetic analogue of 8-arginine vasopressin (ADH), is an antidiuretic . 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. Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. PDF DDAVP Injection (desmopressin acetate) - Sanofi Fosinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil.