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DDAVP
desmopressin
Black Box Warnings .
Hyponatremia (Injectable Form)
severe hyponatremia may be life-threatening, leading to seizures, coma, respiratory arrest, or death; contraindicated in patients with severe hyponatremia risk including excessive fluid intake, fluid/electrolyte imbalances, or concurrent loop diuretics or systemic/inhaled glucocorticoids; ensure normal serum Na before starting or resuming tx; monitor Na within 7 days and x1mo after tx start, then periodically or more frequently in patients 65 yo and older or if hyponatremia risk; consider temporarily or permanently D/C if hyponatremia occurs
Adult Dosing .
Dosage forms: TAB: 0.1 mg, 0.2 mg; INJ: various
diabetes insipidus, central
- [PO route]
- Dose: 0.1-1.2 mg/day PO divided bid-tid; Start: 0.05 mg PO bid; 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 approximately 1/10 of intranasal dose; restrict fluid intake >1h before until >8h after administration
hemophilia A
- [0.3 mcg/kg/dose IV x1]
- Max: 20 mcg/dose; 3 days; Info: for patients with factor VIII levels >5% without factor VIII antibodies; may repeat dose in 8-12h, then q24h thereafter; if preop, give 30min before surgery; restrict fluid intake >1h before until >8h after administration with repeat doses
type I von Willebrand disease, mild-moderate
- [0.3 mcg/kg/dose IV x1]
- Max: 20 mcg/dose; 3 days; Info: for patients with factor VIII levels >5%; may repeat dose in 8-12h, then q24h thereafter; if preop, give 30min before surgery; restrict fluid intake >1h before until >8h after administration with repeat doses
uremic bleeding (off-label)
- [0.3 mcg/kg/dose SC/IV x1]
- Info: IV route preferred to SC route
renal dosing
- [uremic bleeding (off-label)]
- renal impairment: not defined
- HD/PD: not defined
- [all other indications]
- CrCl <50: contraindicated
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: TAB: 0.1 mg, 0.2 mg; INJ: various
diabetes insipidus, central
- [PO route, 4 yo and older]
- Dose: 0.1-1.2 mg/day PO divided bid-tid; Start: 0.05 mg PO bid; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; restrict fluid intake
- [parenteral route, 12 yo and older]
- Dose: 2-4 mcg/day SC/IV divided qd-bid; Info: parenteral dose is approximately 1/10 of intranasal dose; restrict fluid intake
nocturnal enuresis, primary
- [6 yo and older]
- Dose: 0.2-0.6 mg PO qhs; Start: 0.2 mg PO qhs; Max: 0.6 mg/day; Info: restrict fluid intake >1h before administration until next morning or >8h after administration
hemophilia A
- [3 mo and older]
- Dose: 0.3 mcg/kg/dose IV x1; Max: 20 mcg/dose; 3 days; Info: for patients with factor VIII levels >5% without factor VIII antibodies; may repeat dose in 8-12h, then q24h thereafter; if preop, give 30min before surgery; restrict fluid intake >1h before until >8h after administration with repeat doses
type I von Willebrand disease, mild-moderate
- [3 mo and older]
- Dose: 0.3 mcg/kg/dose IV x1; Max: 20 mcg/dose; 3 days; Info: for patients with factor VIII levels >5%; may repeat dose in 8-12h, then q24h thereafter; if preop, give 30min before surgery; restrict fluid intake >1h before until >8h after administration with repeat doses
uremic bleeding (off-label)
- [3 mo and older]
- Dose: 0.3 mcg/kg/dose SC/IV x1; Info: IV route preferred to SC route
renal dosing
- [uremic bleeding (off-label)]
- renal impairment: not defined
- HD/PD: not defined
- [all other indications]
- CrCl <50: contraindicated
- HD/PD: not defined
hepatic dosing
- [not defined]