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Desmopressin nasal may cause serious and possibly life-threatening hyponatremia (low level of sodium in your blood). Tell your doctor if you have or have ever had a low level of sodium in your blood, are thirsty much of the time, drink large amounts of fluids, or if you have syndrome of inappropriate antidiuretic hormone (SIADH; condition in which the body produces too much of a certain natural substance that causes the body to retain water), or kidney disease. Also tell your doctor if you have an infection, a fever, or a stomach or intestinal illness with vomiting or diarrhea. Tell your doctor if you experience any of the following during your treatment: headache, nausea, vomiting, restlessness, weight gain, loss of appetite, irritability, fatigue, drowsiness, dizziness, muscle cramping, seizures, confusion, loss of consciousness, or hallucinations.
Tell your doctor if you are taking a loop diuretic ("water pills") such as bumetanide, furosemide (Lasix), or torsemide; an inhaled steroid such as beclomethasone (Beconase, QNasl, Qvar), budesonide (Pulmicort, Rhinocort, Uceris), fluticasone (Advair, Flonase, Flovent), or mometasone (Asmanex, Nasonex); or an oral steroid such as dexamethasone, methylprednisolone (Medrol), or prednisone (Rayos). Your doctor will probably tell you not to use desmopressin nasal if you are using or taking one of these medications.
Keep all appointments with your doctor and the laboratory. Your doctor will order tests to monitor your sodium levels before and during your treatment to check your body's response to desmopressin nasal.
Talk to your doctor about the risk(s) of using desmopressin nasal.
WHY is this medicine prescribed?
Desmopressin nasal (DDAVP®) is used to control the symptoms of a certain type of diabetes insipidus ('water diabetes'; condition in which the body produces an abnormally large amount of urine). Desmopressinnasal (DDAVP®) is also used to control excessive thirst and the passage of an abnormally large amount of urine that may occur after a head injury or after certain types of surgery. Desmopressin nasal (Noctiva®) is used to control frequent nighttime urination in adults who awaken at least 2 times per night to urinate. Desmopressin nasal (Stimate®) is used to stop some types of bleeding in people with hemophilia (condition in which the blood does not clot normally) and von Willebrand's disease (a bleeding disorder) with certain blood levels. Desmopressin nasal is in a class of medications called antidiuretic hormones. It works by replacing vasopressin, a hormone that is normally produced in the body to help balance the amount of water and salt.
HOW should this medicine be used?
Desmopressin nasal comes as a liquid that is administered into the nose through a rhinal tube (thin plastic tube that is placed in the nose to administer medication), and as a nasal spray. It is usually used one to three times a day. When desmopressin nasal (Stimate®) is used to treat hemophilia and von Willebrand's disease, 1 to 2 spray(s) are given daily. If Stimate® is used before surgery, it is usually given 2 hours before the procedure. When desmopressin nasal (Noctiva®) is used to treat frequent nighttime urination, one spray is usually given in either the left or right nostril 30 minutes before going to bed. Use desmopressin nasal at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use nasal desmopressin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Desmopressin nasal spray (Noctiva) is available in two different strengths. These products cannot be substituted for each other. Each time you have your prescription filled, make sure that you have received the right product. If you think you received the wrong strength, talk to your doctor and pharmacist right away.
Your doctor may start you on a low dose of desmopressin nasal and adjust your dose depending on your condition. Follow these directions carefully.
If you will be using the nasal spray, you should check the manufacturer's information to find out how many sprays your bottle contains. Keep track of the number of sprays you use, not including the priming sprays. Discard the bottle after you use the stated number of sprays, even if it still contains some medication, because additional sprays might not contain a full dose of medication. Do not try to transfer the leftover medication to another bottle.
Before you use desmopressin nasal for the first time, read the written instructions that come with the medication. Be sure that you understand how to prepare the bottle before the first use and how to use the spray or rhinal tube. Ask your doctor or pharmacist if you have any questions about how to use this medication.
Are there OTHER USES for this medication?
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
What SPECIAL PRECAUTIONS should I follow?
Before using desmopressin nasal,
What SPECIAL DIETARY instructions should I follow?
Your doctor may tell you to limit the amount of fluid you drink, especially in the evening, during your treatment with desmopressin. Follow your doctor's directions carefully to prevent serious side effects.
What should I do IF I FORGET to take a dose?
If you are using desmopressin nasal (DDAVP®) or (Stimate®) and miss a dose, use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.
If you are using desmopressin nasal (Noctiva®) and miss a dose, skip the missed dose and take the next dose at your regular time. Do not use a double dose to make up for a missed one.
What SIDE EFFECTS can this medicine cause?
Desmopressin nasal may cause side effects. Call your doctor if any of the following symptoms are severe or do not go away:
Some side effects may be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
Desmopressin nasal may cause other side effects. Tell your doctor if you experience any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I do in case of OVERDOSE?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include:
What should I know about STORAGE and DISPOSAL of this medication?
Keep the nasal sprays in the container it came in, tightly closed, and out of reach of children.
Store Stimate® nasal spray upright at a room temperature not to exceed 25°C; discard the nasal spray 6 months after opening it.
Store DDAVP® nasal spray upright at 20 to 25°C. Store DDAVP® rhinal tube at 2 to 8°C; closed bottles are stable for 3 weeks at 20 to 25°C.
Before opening Noctiva® nasal spray, store it upright at 2 to 8°C. After opening Noctiva®, store the nasal spray upright at 20 to 25°C; discard it after 60 days.
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org
What OTHER INFORMATION should I know?
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.
¶ This branded product is no longer on the market. Generic alternatives may be available.
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: May 24, 2017.