desmopressin iv to po conversion

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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Quinapril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. 2022 Mar 8;7(1):e000852. Caution should be exercised when desmopressin is administered to a woman who is breast-feeding. Oral: 0.05 mg twice a day. If administered more than once a day, adjust for an adequate diurnal rhythm of urine output. Chlorpropamide: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including chlorpropamide. Repeat administration should be determined by laboratory response and clinical condition of the patient. endobj 100 unit / 100 ml (1 unit/ml). This places the solution in the nasal cavity and not down your throat.After use, reseal the dropper tip and close the bottle. According to the Beers Criteria, desmopressin is considered a potentially inappropriate medication (PIM) in geriatric adults and avoidance is recommended for treating nocturia or nocturnal polyuria because there is a high risk of hyponatremia and safer alternatives are available. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. For All Patients Receiving Repeated Doses: Patients changing from intranasal desmopressin: We comply with the HONcode standard for trustworthy health information. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin is contraindicated in patients with moderate to severe renal impairment (e.g., CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2). As of 2007 in response to a FDA request for removal of the indication, the intranasal formulation is no longer indicated for the treatment of primary nocturnal enuresis secondary to post-marketing reports of hyponatremic-related seizures, which most often occurred in pediatric patients. Generic Name. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Hydrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Confirm responsiveness before using desmopressin for therapeutic interventions. 2002 Jun;89(9):855-62 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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 adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended. 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. Usual dilution: 0.1 mcg/mL. Also assess serum sodium and aPTT prior to treatment. It is not known whether antibodies to desmopressin injection are produced after repeated injections. DOSAGE AND ADMINISTRATION Hemophilia A and von Willebrand's Disease (Type I): Desmopressin Acetate Injection 4 mcg/mL is administered as an intravenous infusion at a dose of 0.3 mcg desmopressin acetate/kg body weight diluted in sterile physiological saline and infused slowly over 15 to 30 minutes. The pharmacokinetics of 400 microg of oral desmopressin in elderly patients with nocturia, and the correlation between the absorption of desmopressin and clinical effect. Ketorolac (Toradol) Maintenance dose range: 10 mcg/day to 30 mcg/day intranasally (0.1 mL/day to 0.3 mL/day) in 1 to 2 divided doses. Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. [42295], 2 to 4 mcg IV or subcutaneously given in 1 or 2 divided doses daily. 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. Tilt bottle so that the tube inside the bottle draws from the deepest portion of the medication.To avoid the spread of infection, do not use the container for more than 1 person.For 5 mL bottles, discard after 50 sprays (doses), and for 2.5 mL bottles, discard after 25 sprays (doses) because the amount delivered thereafter per spray may be substantially less than the recommended dose. Benazepril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. [61810], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. The pump will stay primed for up to 1 week. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ketorolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 1999 Dec;84 Suppl 1:5-8 If patients are receiving intranasal therapy, begin oral therapy 12 hours after the last intranasal dose. Thiazide diuretics: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 1.2 mg/day PO, 4 mcg/day SC/IV; Alt: 2-4 mcg/day SC/IV divided qd-bid; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; parenteral dose is approx. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Mefenamic Acid: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. 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. Chlorpheniramine; 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. The mean (95% CI) AUC at night was 302 (272-335) pg x h/ml and in the day was 281 (253-312) pg x h/ml. % The peak cerebrospinal fluid concentrations are 60% greater with IV administration than with PO and 87% greater with IV administration than with PR. Valdecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. 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. 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. Dosage: (For neonatal dosages, refer to Neonatal IV Drug Manual.) On Days 1, 3 and 5, subjects were dosed intranasally with escalating doses of AV002 nasal spray. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. 1. If used to reduce spontaneous or traumatic bleeding, doses may be repeated after 8 hours to 12 hours and once daily thereafter, if needed, based upon clinical condition and von Willebrand factor and factor VIII levels. Desmopressin is administered intravenously or subcutaneously.Desmopressin (DDAVP) injection has an antidiuretic hormone activity of 16 International Units/mL; 1 mcg desmopressin is equivalent to 4 International Units antidiuretic hormone activity.If given preoperatively, desmopressin injection should be given 30 minutes before the scheduled procedure.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. Ther Drug Monit. Fatal anaphylaxis has been reported with intravenous desmopressin. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. BJU Int. 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. Consider other treatment options for this condition. Methylprednisolone: (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. Caution should be used when coadministering these agents. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Olmesartan; 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. Desmopressin works by limiting the amount of water passed in the urine. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The distribution of the drug is unknown, and it is not clear whether desmopressin crosses the placenta. 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. Desmopressin is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min). Two children with diabetes insipidus had decreasing desmopressin requirements with lamotrigine initiation. Find medical information for DDAVP on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. Budesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Direct intravenous injectionNo dilution necessary.Inject IV over 1 minute. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Methyclothiazide: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Infusion Pump Required. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Amlodipine; Valsartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. In general, most reported clinical experience with desmopressin has not identified efficacy response differences between geriatric and younger patients. Initially, 0.2 mg PO once daily at bedtime. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. 1 After the original clinical study performed in Italy, desmopressin was used in endobj Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 2005 Apr;95(6):804-9. doi: 10.1111/j.1464-410X.2005.05405.x. Permanently discontinue for serious hypersensitivity reaction. endobj It is chemically defined as follows: Mol. The frequency of dosing varies with patient responses. To prime, press down 4 times. CAREFULLY BEFORE ACCESSING OR USING THIS SITE. Prednisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses. In certain clinical situations, it may be justified to try DDAVP in patients with factor VIII levels between 2% to 5%; however, these patients should be carefully monitored. Use this combination with caution, and monitor patients for signs and symptoms of hyponatremia. Management focuses on controlling symptoms with drug therapy. %f2fDWBRex1*s GZhlNx;hI>l!dKc:cmEg2&M*?*q$|sa[`ov#1q=[`0GP/==g5>dof?N~;1Y Use combination with caution, and monitor patients for signs and symptoms 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. ! Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. Individualize dosing to prevent an excessive decrease in plasma osmolality, which can lead to hyponatremia and possible seizures. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. DDAVP, Minirin, Nocdurna, Stimate, +2 more. Commonly central DI is treated with desmopressin. IV infusion IV Infusion IV Infusion (OB) Only REGULAR insulin may be administered by the IV route. If the patient was previously receiving desmopressin tablets, dose titration is required because intranasal desmopressin is approximately 10 to 40 fold more potent than oral (tablet) desmopressin. The previously recommended dose: 20 mcg (0.2 mL) intranasally of the 0.01% nasal solution at bedtime, with one-half of the dose administered into each nostril. The presence of platelet-vWF and normally functioning platelet glycoprotein (GP) IIb/IIIa seem to be essential for desmopressin's effect on platelets. Desmopressin is a strong V2 agonist and has no effect on V1 receptors. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 2 0 obj When DDAVP /Desmopressin Injection is used for diagnostic purposes, fluid intake must be limited and not exceed 0.5 litres from 1 hour before until 8 hours after administration. The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. No adverse developmental outcomes were observed in animal reproduction studies with administration of desmopressin during organogenesis to pregnant rats and rabbits at doses approximately less than 1 and 38 times, respectively, the maximum recommended human dose based on body surface area (mg/m2). Desmopressin is a synthetic analog of vasopressin used to reduce renal excretion of water in central diabetes insipidus and nocturia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. National Library of Medicine Formoterol; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of 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. If used preoperatively, administer 30 minutes prior to the procedure. Blood pressure and heart rate monitoring during infusion is recommended. 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. 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 . 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 easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Dexamethasone: (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. Of course, hypertonic bicarbonate could also be used, as discussed last week. Desmopressin is contraindicated in persons with hyponatremia or a history of hyponatremia, polydipsia, concomitant loop diuretic or systemic or inhaled corticosteroid therapy, known or suspected syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and other illnesses that can cause fluid and electrolyte imbalance, such as gastroenteritis, salt-wasting nephropathies, or systemic infection. Initially, 0.05 mg PO once daily. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Preserve in tight containers, protected from light. ea1`-@te3;plr*5L%5Ko=UNed Desmopressin is also used to control bed-wetting. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. The bioavailability was 0.08%. Clipboard, Search History, and several other advanced features are temporarily unavailable. <> 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. The recommended maintenance dose is 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. No statistically significant differences were detected between night and day except for terminal half-life, which was 3.1 h at night and 2.8 h in the daytime (P=0.02). Dose should be reduced. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Desmopressin. Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Bioavailability was estimated using AUC(0-->t) for the oral and the intravenous periods. Federal government websites often end in .gov or .mil. Decrease bleeding following cardiac bypass: 0.3 mcg/kg ivpb. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. Bookshelf Monitor blood pressure and pulse during infusion. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Bioavailability and pharmacokinetics of desmopressin in elderly men. Administration of intranasal desmopressin may be compromised by nasal mucosa changes (e.g., nasal trauma, nasal surgery, nasal blockage, nasal mucosal atrophy, congestion, or severe atrophic rhinitis), cranial surgery, and nasal packing. 2005 Oct;27(5):655-65. doi: 10.1097/01.ftd.0000168293.48226.57. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. 3 0 obj The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Gasthuys E, Dossche L, Michelet R, Nrgaard JP, Devreese M, Croubels S, Vermeulen A, Van Bocxlaer J, Walle JV. A woman who took both desmopressin and ibuprofen was found in a comatose state. This is probably due to saturation of receptor sites. DrugBank Accession Number. stream 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 starting dose is 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 2022 Mar 2;12(3):389. doi: 10.3390/biom12030389. Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Do not use desmopressin as sole therapy in persons with vWD undergoing major surgery. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. IV: 0.3 mcg/kg once slowly over 15-30 minutes. <> Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. The necessity for repeat administration of desmopressin acetate or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. A woman who took both desmopressin and ibuprofen was found in a comatose state. The administration of carbamazepine prior to administration of desmopressin may act to reduce the duration of action of desmopressin. Fluid intake restrictions in these patients are recommended. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.

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