Desmopressin

Administration

• Type: synthetic replacement for vasopressin
• Dosage Forms:
  • injectable solution: 4 mcg/mL
  • tablet: 0.1 mg, 0.2 mg
  • nasal spray: 0.1 mg/ mL (5mL); Delivers 10 mcg/spray, 1.5 mg/mL (2.5mL); Delivers 150 mcg/spray
• Routes of Administration: IV, IM, SC, intranasal, oral
• Common Trade Names: DDAVP, Stimate

Adult Dosing

Diabetes Insipidus

• Intranasal: 10-40 mcg/day qday or divided q8-12 hr
• PO:
  • Initial: 0.05 mg q 12 hr
  • Effective range: 0.1-1.2 mg divided q 8-12 hr
• IV/SC: 2-4 mcg/day divided q12 hr or 1/10th the maintenance of intranasal dose

Hemophilia A & Von Willebrand Disease

• IV: 0.3 mcg/kg IV over 15-30 minutes IV (for pre-op 30 min before procedure)
• intranasal:
  • <50 kg: 150 mcg; for pre-op, give 2 hr before procedure
  • >50 kg: 300 mcg; for pre-op, give 2 hr before procedure

Nocturnal Enuresis

• 0.2 mgPO qHS (up to 0.6mg/day)

Uremic Bleeding in Acute or Chronic Renal Failure

• 0.4 mcg/kg IV over 10 minutes

Pediatric Dosing

Diabetes Insipidus

3 months to 12 years (intranasal)

• 5-30 mcg/day qday or divided q12 hr (using 100 mcg/mL solution)

>12 years (intranasal)

• 10-40mcg/day qday or divided q12 hr (using 100 mcg/mL solution)

3 months to 12 years (oral)

• Initial: 0.05 mg q 12 hr
• Effective range: 0.1-1.2 mg

>12 years (oral)

• Initial 0.05 mg PO q 12 hr
• Effective range: 0.1-1.2 mg divided q8-12 hr

3 months to 12 years (IV/SC)

• 0.1-1 mcg qday or divded q12 hr

>12 years (IV/SC)

• 2-4 mcg/day divided q 12 hr or one tenth the maintenance of intranasal dose

Nocturnal Enuresis

• >6 years: 0.2 mg PO qHS; up to 0.6 mg/day

Hemophilia A & Von Willebrand Disease

• 0.3 mcg/kg IV over 15-30 minutes; for pre-op, give 30 minutes before procedure
• 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight
• administer single spray (150 mcg) if patient >12 years of age but <50 kg body weight
• (Fluid intake should be limited 1 hr prior to dose until the next morning or at least 8 hr after administration)

Special Populations

• Pregnancy Rating:
• Lactation risk:

Renal Dosing

• Adult:
• Pediatric:

Hepatic Dosing

• Adult:
• Pediatric:

Contraindications

• Allergy to class/drug

Pharmacology

• Half-life:
• Metabolism:
• Excretion: