Adult Dosing
Neurohypophyseal diabetes insipidus [desmopressin (generic), DDAVP/Minirin/DDAVP Rhinal Tube]
- 10–40 mcg/day (0.1–0.4 mL or 1–4 sprays) intranasally divided qd-tid
- Usual: 20 mcg in 2 divided doses
- Max: 40 mcg/day
Primary nocturnal enuresis (Minirin)
- 20 mcg or 0.2 mL solution intranasally at bedtime
- Max: 40 mcg/day
Hemophilia A and von Willebrand's disease Type I (Stimate)
Adults
- (< 50 kg): 150 mcg intranasally 2 hrs prior to surgery. May repeat in 8-24 hrs
- (> 50 kg): 300 mcg intranasally (150 mcg/nostril) 2 hrs prior to surgery. May repeat in 8-24 hrs
Uremic bleeding (not FDA approved)
- 3 mcg/kg intranasally as a single dose
Pediatric Dosing
Neurohypophyseal diabetes insipidus [desmopressin (generic), DDAVP/Minirin/DDAVP Rhinal Tube]
- 3 mo-12 yrs: 5-30 mcg/day (0.05-0.3 mL) intranasally divided qd-qid
- > 12 yrs: 10–40 mcg/day (0.1–0.4 mL or 1–4 sprays) intranasally divided qd-tid; usual 20 mcg in 2 divided doses; Max: 40 mcg/day
- Note: Use rhinal tube delivery for doses not in 10 mcg increments
Hemophilia A and von Willebrand's disease Type I (Stimate)
> 11 mo
- (< 50 kg): 150 mcg intranasally 2 hrs prior to surgery. May repeat in 8-24 hrs
- (> 50 kg): 300 mcg intranasally (150 mcg/nostril) 2 hrs prior to surgery. May repeat in 8-24 hrs
Primary nocturnal enuresis (Minirin)
>6 yrs
- 20 mcg or 0.2 mL solution intranasally at bedtime
- Max: 40 mcg/day
Uremic bleeding (not FDA approved)
- Child > 3 mo: 3 mcg/kg intranasally as a single dose
[Outline]
- Intranasal route is indicated only when oral formulations are not feasible
- Rare reports of hyponatremia from postmarketing experience; potent antidiuretic, may lead to water intoxication and/or hyponatremia. Fluid restriction recommended
- Use with caution in patients with habitual or psychogenic polydipsia; increased risk of hyponatremia due to consumption of excessive amounts of water, and in patients on drugs that may cause them to drink more fluids, such as tricyclic antidepressants and selective serotonin re-uptake inhibitors (SSRIs)
- Observe all patients for signs/symptoms of hyponatremia viz headache, nausea/vomiting, decreased serum sodium, weight gain, restlessness, fatigue, lethargy, disorientation, depressed reflexes, loss of appetite, irritability, muscle weakness, muscle spasms or cramps and abnormal mental status such as hallucinations, decreased consciousness and confusion
- Rare severe allergic reactions may occur
- Parenteral therapy is indicated if nasal mucosa changes such as scarring, edema, are present
- Monitor urine volume and osmolality at baseline and at frequent intervals
Cautions: Use cautiously in
- Renal impairment (refer dosage adjustment section)
- Known or suspected CAD
- Hypertension
- Thrombosis risk
- Fluid and electrolyte imbalance
- CHF
- Cystic fibrosis
- Geriatric population
- Pediatric population
Pregnancy Category:B
Breastfeeding: Minimally excreted in breast milk and poorly absorbed orally by the infant; appears acceptable to use during breastfeeding.
Pricing data from www.DrugStore.com in U.S.A.
- DDAVP 0.01 % SOLN [Bottle] (SANOFI-AVENTIS U.S.)
5 % = $267.98
15 % = $786.01 - Desmopressin Ace Rhinal Tube 0.01 % SOLN [Bottle] (FERRING)
2.5 % = $86.36
7.5 % = $230.98 - Desmopressin Ace Spray Refrig 0.01 % SOLN [Bottle] (BAUSCH & LOMB)
5 % = $209.99
15 % = $625.97 - DDAVP Rhinal Tube 0.01 % SOLN [Bottle] (SANOFI-AVENTIS U.S.)
2.5 % = $154.52
7.5 % = $459.81 - Stimate 1.5 MG/ML SOLN [Bottle] (CSL BEHRING)
2.5 ml = $649.01
5 ml = $1292.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
