Initially, 0.2 mg PO once daily at bedtime. 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 Indomethacin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Codeine; Phenylephrine; Promethazine: (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. Bethesda, MD 20894, Web Policies IV: 100 mg IV bolus given immediately, followed by 25 to 75 mg IV every 6 hours or 200 mg/24 hours as a continuous IV infusion for the first 24 hours. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 2002 Jun;89(9):855-62 Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 6 years or older: Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. Use this combination with caution, and monitor patients for signs and symptoms of hyponatremia. Preoperative doses may be given 2 hours prior to the scheduled procedure. Intravenous desmopressin should be considered when indicated. Carbetapentane; Diphenhydramine; 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. <>
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. The recommended maintenance dose is 5 mcg/day to 30 mcg/day (0.05 mL/day to 0.3 mL/day) intranasally in single or divided doses. Desmopressin in nocturnal enuresis 677,ug given intranasally wasequivalent to 400[ig given orally.8 Wedecidedto comparethe 20 igintranasal dose with the 200 tg oral dose, whichwefoundin a pilot study to be as effective as a 400 ptg dose, but with less effect on serum electrolytes and body weight. Desmopressin is a synthetic analog of vasopressin used to reduce renal excretion of water in central diabetes insipidus and nocturia. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Use combination with caution and monitor patients for signs and symptoms of hyponatremia, which may include seizures. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Chlorothiazide: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. MeSH May repeat dose if needed. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
BJU Int. Confirm responsiveness before using desmopressin for therapeutic interventions. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Metolazone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Adjust dose based upon response to treatment estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. DrugBank Accession Number. Bookshelf However, individualized dosing is recommended due to high inter-patient variability in response. The plasma concentrations generally declined below 2 pg/mL (lower limit of quantitation) 4 to 6 hours post-dose. Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Diclofenac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. ADH activity : Pressor activity [DDAVP: 2000-4000: 1 Vasopressin: 1:1]. documenting the conversion using the "IV to PO conversion" category. In a single study of postpartum women receiving a single dose of intranasal desmopressin, a marked change in plasma concentration of desmopressin was seen; however, little, if any, change in assayable desmopressin was found in breast milk. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. So, if a patient is on a nasal (spray or intranasal) dose of 10mcg (0.1 ml) twice a day, then a suitable tablet oral dose may be 100mcg or 200mcg twice a day. Intranasal: Consider risk vs. benefit as pregnant women with Hemophilia A or von Willebrand's disease as these patients may be at an increased risk for bleeding diatheses and hemorrhagic events at delivery; affected neonates may also be at risk of bleeding diatheses. 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. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. Greatly enhanced ADH activity. What is the standard conversion technique to calculate those dosages from a typical. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Caution should be exercised when desmopressin is administered to a woman who is breast-feeding. There is no increase in activity with doses greater than 0.4 mcg/kg, despite increases in desmopressin concentrations. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. It may be given in the nose, by injection into a vein, by mouth, or under the tongue. Persons with renal disease may be at increased risk for low sodium concentrations, fluid overload, and electrolyte abnormalities. 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. 2022 Mar 8;7(1):e000852. If the product has not been used for more than 3 days, re-prime by pumping 2 actuations into the air.Instruct the patient to blow their nose, tilt the head back slightly, and insert the nasal applicator into the left or right nostril, keeping the nasal applicator upright. Adjust doses based on patient's diurnal pattern of response. Treatment with ddAVP improves platelet-based coagulation in a rat model of traumatic hemorrhagic shock. SOLU CORTEF IV TO PO CONVERSION - CHRISTIANTUTTL2'S BLOG. Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task. Permanently discontinue for serious hypersensitivity reaction. Clipboard, Search History, and several other advanced features are temporarily unavailable. Proposed sites of these receptors include endothelial cells, megakaryocytes, blood monocytes, and mast cells. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. LV>T6If7>LYJTgJ^kyf>[7Sz]>mCh^3r3a2Lmm$9_5y/;D|s
}3a7+NGv46p?MISiZ?dV?pmSosEIN.6DLY}%OL!+Cuf^C;\EvwgOv|2> V,>1w|>>O[[ej,UdSg,ufiEI'&c3Y_$x_'Ifm9s;KY|{AuLTiv[V>n~>r`-@Z(^++Gj~Stsz|6jmm/1dEIz$+ZE7c0rw@GRt=%K2*#g`9'Jp?Hol+c/1K6//1-=d#~t*8t)~H0E>ue)'U'$L {+/7VPerb}6Wz+>8. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Unable to load your collection due to an error, Unable to load your delegates due to an error. Example: Ampicillin-sulbactam 1.5gm IV Q6H to amoxicillin-clavulanic acid 875mg/125mg PO Q12H. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 1997;183:53-4. Terminal half-life was longer at night than in the daytime, but the difference is considered too small to be of clinical importance. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin injection is used to control frequent urination and increased thirst caused by certain types of brain injury or brain surgery. For bleeding, desmopressin increases the blood levels of factor VIII and von Willebrand . The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Children more than 12 years of age: 0.3 to 0.4 mcg/kg/dose IV or subcutaneously once. There are several recommended conversions ranging from 50 to 80% of the oral dose but the American Association of Clinical Endocrinologists/American Thyroid Association guidelines recommend an intravenous dose 50-70% of the patient's oral dose. A woman who took both desmopressin and ibuprofen was found in a comatose state. Oral: 0.05 mg twice daily. In the elderly, careful dosage selection and monitoring of renal function are recommended. The time to reach maximum plasma desmopressin levels is 0.9 hours. 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. Chlorpheniramine; Dihydrocodeine; 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. The pump will stay primed for up to 1 week. Dosing: Diabetes Insipidus 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 . IV: 0.3 mcg/kg once slowly over 15 to 30 minutes. 27.7 mcg sublingually once daily, 1 hour before bedtime without water. An official website of the United States government. Blood pressure and pulse should be monitored during infusion. Valdecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). . 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. Rotoli BM, Visigalli R, Ferrari F, Ranieri M, Tamma G, Dall'Asta V, Barilli A. Biomolecules. 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. Monitor patients for signs or symptoms of hypersensitivity reactions during administration, interrupt treatment should a reaction occur, and manage medically. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. 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. Pretreatment Testing and On-Treatment Monitoring Diabetes Insipidus Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. official website and that any information you provide is encrypted The night-time dosing and daytime intravenous dose resulted in antidiuresis throughout the measuring period, while the effect of the daytime peroral dose receded after 6 h. Conclusion: More than 50 kg: 150 mcg in each nostril. Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. Hydralazine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. IV: 0.3 mcg/kg by slow infusion over 15-30 minutes beginning 30 minutes before procedure. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. DDAVP will also stop bleeding in hemophilia A patients with episodes of spontaneous or trauma-induced injuries such as hemarthroses, intramuscular hematomas or mucosal bleeding. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Caution should be used when coadministering these agents. In general, desmopressin is contraindicated in persons with heart failure or uncontrolled hypertension because fluid retention increases the risk for worsening of underlying conditions that are susceptible to volume status. -. Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. endobj
Saint-Prex, Switzerland - 21 June, 2022 - Minirin (desmopressin) Nasal Spray 0.1 mg/ml room temperature stable (RTS)/ Octostim (desmopressin) Nasal Spray 1.5 mg/ml/ DDAVP (desmopressin acetate, 10 mcg/0.1 mL)/ Stimate (desmopressin acetate, 1.5 mg/1 mL) Nasal Spray/ Generic Desmopressin Acetate (10 mcg/0.1mL) Nasal Spray - Recall and Production Hold Statement peak plasma concentration (Cmax) was 4 (+/- 3.85) pg/mL for the 0.83 mcg dose and 9.11 (+/- 6.90) pg/mL for the 1.66 mcg dose. 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. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. Following oral administration, the half-life of desmopressin is about 1.5 to 2.5 hours and is independent of dosage. Caution should be used when coadministering these agents. Once the dose is in the tube, hold the tube with your fingers, about 3/4 inch from the end.Put the tube into a nostril, until your fingers touch the nostril. 0.2 to 0.6 mg orally once daily before bedtime. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. There is no information on the effects of desmopressin on the breast-fed infant or on milk production. Dosage adjustments of desmopressin may be necessary to maintain proper sodium and water balance. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Furosemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. A desmopressin response requires an increase of at least 2 times the baseline von Willebrand factor (vWF) activity and an increase of both vWF and factor VIII concentrations of more than 0.5 International Units/mL for at least 4 hours. Vincristine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. .2/ZfG[:{oH}ZJUmniOF F.\6K"abU:hiVyz6gAKt_|pgrqx9MUWz,_LgMvU ?>MJx
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