Flunisolide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Children more than 12 years of age: Heparin: (Minor) Desmopressin has been shown to have an additive effect on the anticoagulant activity of heparin. DDAVP (2 micrograms IV q8hr) is started immediately and continued until the sodium is close to normal. A woman who took both desmopressin and ibuprofen was found in a comatose state. A comparison was made of intranasal administration of 300 micrograms desmopressin (DDAVP) by spray, with intravenous administration of 0.2, 0.3 and 0.4 microgram DDAVP/kg in 10 healthy volunteers. Hydrocodone; Ibuprofen: (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). Carbetapentane; 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. 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. Levels of FVIII are also increased, which increases hemostasis by accelerating fibrin formation. Which lab value should prompt the nurse to question a medication dosage increase? Losartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Loop diuretics: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Azelastine; Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Following oral administration, the half-life of desmopressin is about 1.5 to 2.5 hours and is independent of dosage. 5 to 40 mcg spray intranasally twice a day or 8600 Rockville Pike 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. You can adjust the side column for all the news articles in the 'side column' tab above endobj 150 mcg into each nostril once for a total dose of 300 mcg. Administer with a 0.22 micron filter. Initially, 0.05 mg PO twice daily. endobj Infants 3 months of age to children 12 years of age: Brand Names. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). DB00035. Interrupt therapy for acute illness (e.g., systemic infection, fever, recurrent vomiting or diarrhea), extremely hot weather, vigorous exercise, or other conditions associated with increased water intake. Initial dose: 0.05 mg orally twice a day or Repeat administration should be determined by laboratory response and clinical condition of the patient. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Factors associated with mortality of myxedema coma: report of eight cases and literature survey. Blood pressure and pulse should be monitored during infusion. 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. Caution should be used when coadministering these agents. Torsemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication.[42295]. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Fluid intake restrictions in these patients are recommended. If doses other than these are required, the rhinal tube delivery system may be used.One spray (10 mcg) has an antidiuretic activity of about 40 International Units.The nasal spray must be primed prior to first use. 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. 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. Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma. Ther Drug Monit. <> endobj 1. 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. When desmopressin is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular pediatric and geriatric patients, fluid intake should be adjusted downward to decrease to potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain). Hemophilia A and von Willebrand's Disease (Type I): The recommended dosage is 0.3 mcg/kg actual body weight (to a maximum of 20 mcg) administered by intravenous infusion over 15 minutes to 30 minutes. Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. Following oral administration, the onset of antidiuretic effect occurs around 1 hour and reaches a maximum at 4 to 7 hours. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. Triamcinolone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. IV: 0.3 mcg/kg once slowly over 15-30 minutes. For bleeding, desmopressin increases the blood levels of factor VIII and von Willebrand . It is not known whether antibodies to desmopressin injection are produced after repeated injections. 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. Baseline renal function should be assessed. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Usual dilution: 0.1 mcg/mL. Study results show the C max of IV acetaminophen is 76% greater than PO and 256% greater than PR. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Telmisartan; 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. Vasopressin, ADH: (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 vasopressin, ADH only with careful patient monitoring. 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. 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. Severe allergic reactions, including anaphylaxis, have been reported with intravenous and intranasal desmopressin. His endocranologist only wants him to use it one time a day, but the problem is he goes to the bathroom sometimes every 15 minutes!!! The Melt dose is then derived from tablet conversion, as . Ketorolac (Toradol) In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. Guardrail Drug Requires documentation of two (2) RN's for double-checking. 1998 Nov;82(5):642-6 The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Deflazacort: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. For desmopressin Desmopressin is an analogue of vasopressin. If used preoperatively, administer 30 minutes before surgery. YES. The pharmacokinetic profile of desmopressin is biexponential. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. 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. It is chemically defined as follows: Mol. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin is not indicated for persons with severe classic vWD (type 1), for the treatment of hemophilia B, or in persons with factor VIII antibodies. Desmopressin injection is used to control frequent urination and increased thirst caused by certain types of brain injury or brain surgery. HOW SUPPLIED Desmopressin Acetate Injection 4 mcg/mL is available as a clear colorless sterile solution as follows: Ampul - 4 mcg/mL - 1 mL - 10 per Box. Prednisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Children more than 12 years of age: 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. CrCl 50 mL/minute or more: No dosage adjustment is needed.CrCl less than 50 mL/minute OR eGFR less than 50 mL/minute/1.73 m2: Use is contraindicated. R8cxz. 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. Greatly enhanced ADH activity. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state.