PDF Information for Patients & Parents / Carers - North Tees and Hartlepool Medication guideline for the management of neonates requiring desmopressin acetate. Last updated on Apr 7, 2022. WBC count of 15,00/mm 2. Clipboard, Search History, and several other advanced features are temporarily unavailable. DDAVP, Stimate (desmopressin) dosing, indications, interactions Bookshelf Pharmacokinetic parameters were derived using a two-compartmental model except for AUC(0-->t), which was derived using non-compartmental analysis. Two children with diabetes insipidus had decreasing desmopressin requirements with lamotrigine initiation. sharing sensitive information, make sure youre on a federal Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. Desmopressin - WikEM Acetaminophen; Dextromethorphan; 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. When administered to patients with central diabetes insipidus, desmopressin exerts antidiuretic effects similar to those of vasopressin; a reduction in urine output with an accompanying increase in urine osmolality and a decrease in clinical symptoms of urinary frequency and nocturia are noted following desmopressin treatment. Persons with vWD type 1 and von Willebrand factor (vWF) concentrations less than 0.3 International Units/mL or factor VIII activity equal to or less than 5% of normal may not respond to desmopressin. 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 Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. If used preoperatively, administer 2 hours before surgery. This medication helps to control increased thirst and too much urination due to these conditions . The risk of toxic reactions (including water intoxication and low sodium concentrations) appears to be greater in the geriatric patient and other patients with impaired renal function. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 1990 Aug;66(2):175-6 Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. However, individualized dosing is recommended due to high inter-patient variability in response. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Bethesda, MD 20894, Web Policies Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. What is the standard conversion technique to calculate those dosages from a typical. Confirm responsiveness before using desmopressin for therapeutic interventions. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. 100 unit / 100 ml (1 unit/ml). Median time to reach Cmax (tmax) was 1.5 (range 1.0-4.1) h at night and 1.5 (range 0.5-3.0) h in the day. Desmopressin, sold under the trade name DDAVP among others, is a medication used to treat diabetes insipidus, bedwetting, hemophilia A, von Willebrand disease, and high blood urea levels. 1995 Apr;42(4):373-8. doi: 10.1111/j.1365-2265.1995.tb02645.x [ PubMed ] 10646654 Yamamoto T, Fukuyama J, Fujiyoshi A. Objective: desmopressin: Dosing, contraindications, side effects, and pill 8600 Rockville Pike FOIA For antimicrobial interchanges: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per protocol. Adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min). 0.02 mg IN, 0.2 mg PO and 0.4 mg PO) have a similar, pronounced pharmacodynamic effect on urine volume and urine osmolality. The use of desmopressin for nocturia is not recommended in pregnant women; nocturia is usually related to normal, physiologic changes during pregnancy that do not require treatment with desmopressin. 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. Metolazone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. Olmesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Following oral administration, the bioavailability of desmopressin is about 5% and 0.16% compared to intranasal and intravenous administration, respectively. Keep this seal as it is reversed to prevent leakage from the dropper.Squeeze the correct dose into this tube from the dropper bottle. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Initially, 0.2 mg PO once daily at bedtime. Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. In the elderly, careful fluid intake restrictions are required to prevent hyponatremia and water intoxication. Desmopressin - UpToDate common IV -> PO conversions & some dosing Flashcards | Quizlet 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. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. Levels of FVIII are also increased, which increases hemostasis by accelerating fibrin formation. Ther Drug Monit. HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. 8-10 mg IV = 40 mg PO. endobj The initial and terminal half-lives for desmopressin are 7.8 and 75.5 minutes, respectively, resulting in a prompt onset of action with a long duration of action. 150 mcg into each nostril once for a total dose of 300 mcg. Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or enteral nutrition and/or receiving oral medications Infection does not require IV antibiotics Afebrile (< 100.4F in the last 24 hours) Received 24 hours of IV antibiotics 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. Intermittent intravenous infusionFor adults and children weighing greater than 10 kg, dilute dose in 50 mL of 0.9% Sodium Chloride for injection. Max IV rate (usual): 5 mg/min. Monitor blood pressure during desmopressin administration, particularly in persons with coronary artery disease (insufficiency) and/or hypertension; desmopressin may cause hypotension (with compensatory increase in heart rate) or hypertension. Dexamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. For All Patients Receiving Repeated Doses: Restrict free water intake and monitor for hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Brompheniramine; Dextromethorphan; 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. Cisplatin can cause hyponatremia, which may increase the risk of water intoxication in patients receiving treatment with desmopressin. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 2005 Oct;27(5):655-65. doi: 10.1097/01.ftd.0000168293.48226.57. A woman who took both desmopressin and ibuprofen was found in a comatose state. Monoamine oxidase inhibitors: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia and SIADH including monoamine oxidase inhibitors (MAOIs). The peak cerebrospinal fluid concentrations are 60% greater with IV administration than with PO and 87% greater with IV administration than with PR. 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. On Day 7, 6 subjects were given a single SC bolus injection of desmopressin. In certain clinical situations, it may be justified to try desmopressin in persons with factor VIII concentrations of 2% to 5%; however, carefully monitor these patients. Longer DOA. 2022 Feb 18;14(4):1057. doi: 10.3390/cancers14041057. Adult dosing should not be used in this age group; adverse events such as hyponatremia-induced seizures may occur. Hydrochlorothiazide, HCTZ; Moexipril: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The .gov means its official. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. A woman who took both desmopressin and ibuprofen was found in a comatose state. Applies to the following strengths: 0.15 mg/inh; 10 mcg/inh; 4 mcg/mL; 0.1 mg; 0.2 mg; 15 mcg/mL; 0.01%; 27.7 mcg; 55.3 mcg; 0.83 mcg/0.1 mL; 1.66 mcg/0.1 mL; 15 mcg/inh. Deflazacort: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Piroxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Treatment has been given safely to pediatric patients for up to 6 months. PDF Intravenous Medication Guidelines for Adults - VCHCA Brompheniramine; 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. Available for Android and iOS devices. Prolonged experience with desmopressin in pregnant women over several decades, based on the available published literature and case reports, have not identified a drug associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. 1 After the original clinical study performed in Italy, desmopressin was used in The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fludrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Fluticasone; Umeclidinium; Vilanterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. IV and subcutaneously: No definitive dosing available. Meny Lukk national monument bank uk; will arnett brothers and sisters 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. This places the solution in the nasal cavity and not down your throat.After use, reseal the dropper tip and close the bottle. Dose range is 0.1 to 0.8 mg daily. 2 0 obj The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diflunisal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. {+/7VPerb}6Wz+>8. Aliskiren; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. Direct intravenous injectionNo dilution necessary.Inject IV over 1 minute. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. HHS Vulnerability Disclosure, Help 2 mg PO - 15 mg IV. Opiate Agonists: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including opiate agonists. 27.7 mcg sublingually once daily, 1 hour before bedtime without water. 50 kg or less: 150 mcg Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia, which may include monitoring serum sodium or electrolytes periodically. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. Although the manufacturer states that nasal congestion does not affect the absorption of intranasal desmopressin, some clinicians recommend a higher dose. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Candesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Despite low bioavailability, the pharmacodynamic effects of oral desmopressin were similar in magnitude to those after intravenous dose at night and during the first 6 h after daytime administration. The following pharmacist will check on these open i-Vents and close then when appropriate. Unauthorized use of these marks is strictly prohibited. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Famotidine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Cisplatin: (Moderate) Frequently monitor serum sodium levels if concurrent use of desmopressin and cisplatin is necessary. DB00035. Dilute DDAVP Injection in sterile 0.9% Sodium Chloride Injection, USP and infuse slowly over 15 minutes to 30 minutes. Last updated on Sep 28, 2022. Dosage form: injection In the elderly, careful dosage selection and monitoring of renal function are recommended. Initially, 0.05 mg PO twice daily. 3 months and older: Dependent on route of administration and indication for therapy.Less than 3 months: Safety and efficacy have not been established. Response should be estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. DDAVP Injection (desmopressin acetate) is a man-made form of a hormone that occurs naturally in the pituitary gland used to treat hemophilia A or von Willebrand's disease Type I, and is also used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. 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. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Federal government websites often end in .gov or .mil. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. Infants 3 months of age and children: Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Olopatadine; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. If 30 mcg is divided, typically 20 mcg is given in the morning, and 10 mcg is given at night. Prednisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 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. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. 4. Background. %PDF-1.7 % Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The recommended dose for women is lower than for men because women are more sensitive to the effects of desmopressin sublingual tablet and had a higher risk of hyponatremia with the 55.3 mcg dose in clinical trials. Desmopressin 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. If used preoperatively, administer 30 minutes prior to the procedure. Amiloride; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Withdraw the necessary volume of DDAVP Injection from the vial and dilute by adding to the infusion bag of 0.9% Sodium Chloride Injection, USP per Table 1. 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. Indications: Hemophilia (increases factor VIII levels): 0.3 mcg/kg in 50ml normal saline over 15-30 minutes. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. Only start or resume therapy in patients with a normal serum sodium concentration. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Tolvaptan: (Major) Coadministration of tolvaptan and desmopressin (DDAVP) is not recommended. Following oral administration, the half-life of desmopressin is about 1.5 to 2.5 hours and is independent of dosage. Geriatric patients 65 years of age and older treated with desmopressin for nocturia had a higher incidence of hyponatremia compared to patients less than 65 years old; therefore, monitor serum sodium more frequently in these patients. 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 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 Prednisolone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Which lab value should prompt the nurse to question a medication dosage increase? Your doctor may adjust the dose as needed. Initiate at low dose and increase as necessary. Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. Adjust doses based on patient's diurnal pattern of response. Unable to load your collection due to an error, Unable to load your delegates due to an error. Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. (PDF) COMPARISON OF DESMOPRESSIN (DDAVP) TABLET AND - ResearchGate Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Use this combination with caution, and monitor patients for signs and symptoms of hyponatremia. Tilt bottle so that the tube inside the bottle draws from the deepest portion of the medication.If given preoperatively, intranasal desmopressin should be administered 2 hours before surgery.To avoid the spread of infection, do not use the container for more than 1 person.Discard spray pump after 25 sprays since the amount delivered thereafter per spray may be substantially less than the recommended dose. The usual dosage range in adults is 0.5 mL (2 mcg) to 1 mL (4 mcg) daily, administered intravenously or subcutaneously, usually in two divided doses. It is not known whether antibodies to desmopressin injection are produced after repeated injections. See Table 1 for volume of diluent to use. Example: Ampicillin-sulbactam 1.5gm IV Q6H to amoxicillin-clavulanic acid 875mg/125mg PO Q12H. Adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. Objective: To investigate (1) the pharmacokinetic and pharmacodynamic profiles of desmopressin in men from an age group with a high incidence of nocturia; and (2) circadian variation in the pharmacokinetic parameters. How can you convert an orally administered dose to intraperitoneal PDF IV to PO Pharmacy Conversion Protocol - FormWeb Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. Desmopressin Intranasal (Noctiva, low dose) Each spray delivers 0.83 to 1.66 mcg Marketed for Nocturia in adults (but other non-medication approaches are preferred) Expensive: $425/month in 2018 Desmopressin Oral Initial: 0.2 mg PO qhs Use lowest effective dose Increase as needed to 0.6 mg at bedtime VII. IV: 0.3 mcg/kg once slowly over 15-30 minutes. Store refrigerated 2 to 8C (36 to 46F). WBC count of 3,000mm 3. [61810], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. 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.
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