Adult Dosing
Neurohypophyseal diabetes insipidus
- Start 0.05 mg PO bid; then adjust according to response
- Usual range: 0.1-1.2 mg/day PO divided bid-tid
- Max: 1.2 mg/day
- When switching from nasal; give 1st PO dose 12 hrs after last nasal dose
- Note: Restrict fluid intake
Primary Nocturnal Enuresis
- 0.2 mg PO qhs; may be titrated up to 0.6 mg to achieve desired response
- Max: 0.6 mg/day
- Note: Restrict fluid intake from 1 hr before administration, until the next morning, or atleast 8 hrs after administration; When Switching from Nasal; give first PO dose 24 hrs after last nasal dose
Pediatric Dosing
Neurohypophyseal diabetes insipidus
Child 
4 yrs
- Start 0.05 mg PO bid; then adjust according to response
- Usual range: 0.1-1.2 mg/day PO divided bid-tid
- Max: 1.2 mg/day
- When switching from nasal; give 1st PO dose 12 hrs after last nasal dose
- Note: Restrict fluid intake
Primary Nocturnal Enuresis
- 0.2 mg PO qhs; may be titrated up to 0.6 mg to achieve desired response
- Max: 0.6 mg/day
- Note: Restrict fluid intake from 1 hr before administration, until the next morning, or atleast 8 hrs after administration; When Switching from Nasal; give first PO dose 24 hrs after last nasal dose
[Outline]
- Rare reports of hyponatremia from postmarketing experience; potent antidiuretic, may lead to water intoxication and/or hyponatremia. Fluid restriction recommended
- Fluid intake should be restricted from 1 hour before to 8 hours after administration of desmopressin tablets
- Use with caution in patients with habitual or psychogenic polydipsia or in patients who are taking drugs that may cause them to drink more fluids, such as tricyclic antidepressants and selective serotonin re-uptake inhibitors (SSRIs); increased risk of hyponatremia due to consumption of excessive amounts of water
- Rare thrombotic events have been reported; use with caution in patients predisposed to thrombus formation
- 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
- Treatment for primary nocturnal enuresis should be interrupted during episodes of fluid and/or electrolyte imbalance, such as fever, recurrent vomiting or diarrhea, vigorous exercise, or other conditions associated with increased water consumption
- Desmopressin (oral) has been used safely in children >4 yr of age; individually adjust dose in children < 4 yrs of age, in order to prevent an excessive decrease in plasma osmolality
- An extreme decrease in plasma osmolality occurs rarely and may result in seizures and coma; Monitor urine volume and osmolality; plasma osmolality
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: Safety unknown; minimally excreted in breast milk and poorly absorbed orally by the infant. Appears acceptable to use during breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 19 August 2010).
Pricing data from www.DrugStore.com in U.S.A.
- Desmopressin Acetate 0.1 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
30 mg = $86.99
90 mg = $231.96 - DDAVP 0.2 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $203.39
90 mg = $584.78 - DDAVP 0.1 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $151.73
90 mg = $408.28
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.
