Flunisolide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Triamterene; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. and transmitted securely. We comply with the HONcode standard for trustworthy health information. Barnabei A, Corsello A, Paragliola RM, Iannantuono GM, Falzone L, Corsello SM, Torino F. Cancers (Basel). Carbamazepine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including carbamazepine. Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. Results: Eprosartan; 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. A systematic review of 30 studies of desmopressin for the treatment and prophylaxis of bleeding disorders in pregnancy (n = 216) concluded that the drug is effective in reducing bleeding complications associated with pregnancy and childbirth with a good safety record. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Initially, 0.05 mg PO twice daily, then titrate to response. Commonly central DI is treated with desmopressin. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia 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. Conversion from injection to intranasal: Administer 10 times the amount of desmopressin acetate, rounded down to the nearest 10 mcg. Every 3 months, Increased Factor VIII activity is noted 30 minutes after intranasal administration, with peak activity occurring in 90 minutes to 2 hours. If used preoperatively, administer 30 minutes prior to the procedure. Desmopressin acetate should not be used to treat patients with Type IIB von Willebrands disease since platelet aggregation may be induced. There is no information on the effects of desmopressin on the breast-fed infant or on milk production. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Persons with vWD subtype 1C, which is characterized by a shorted vWF half-life, may require alternative management in the setting of surgery. Peak plasma concentrations are noted within 40 to 45 minutes of a dose. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Blood samples were taken before and at predetermined time points up to 12 h after dosing. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. eCollection 2022. 1998 Nov;82(5):642-6 Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. May repeat dose if needed. Wash the rhinal tube in water and shake well, until no water is left in the tube.To avoid the spread of infection, do not use the container for more than 1 person.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. Dosage form: injection IV: 1 to 2 mcg twice a day 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. Brompheniramine; 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. A pharmacokinetic and pharmacodynamic comparison of desmopressin administered as whole, chewed and crushed tablets, and as an oral solution. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. A woman who took both desmopressin and ibuprofen was found in a comatose state. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Direct intravenous injectionNo dilution necessary.Inject IV over 1 minute. 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. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10 th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses Hemophilia A and von Willebrand's Disease (Type I): 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. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. Example: Ampicillin-sulbactam 1.5gm IV Q6H to amoxicillin-clavulanic acid 875mg/125mg PO Q12H. Dose should be reduced. The hemostatic effects of desmopressin are mediated through V2 receptor agonist activity, as patients with nephrogenic diabetes insipidus, who lack this receptor, do not have a hemostatic response to desmopressin. During treatment with DDAVP Injection, assess serum sodium, bleeding time, factor VIII coagulant activity, ristocetin cofactor activity, and von Willebrand antigen to ensure that adequate levels are being achieved. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. The patient should close the open nostril with a finger from the empty hand and gently inhale while the nasal applicator is pumped 1 time. 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. Diclofenac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. The pharmacodynamic effects of oral and intravenous desmopressin given in the daytime were similar during the first 6 h after dosing. Noctiva Nasal SprayNoctiva nasal spray delivers either 0.83 mcg or 1.66 mcg of desmopressin acetate (equivalent to 0.75 mcg or 1.5 mcg of desmopressin) per spray (0.1 mL).Two sprays of the 0.83 mcg nasal spray are not interchangeable with 1 spray of the 1.66 mcg nasal spray; the 1.66 mcg/0.1 mL nasal spray should be prescribed for patients who are or will be taking the 1.66 mcg dose.Do NOT shake the bottle.Prime the nasal spray before using for the first time by pumping 5 actuations into the air away from the face. 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. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. In patients receiving desmopressin nasal spray for nocturia, discontinue treatment in patients with concurrent nasal conditions that may increase systemic absorption of desmopressin (e.g., atrophy of nasal mucosa, and acute or chronic rhinitis), because the increased absorption may increase the risk of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 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. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. Blood pressure and heart rate monitoring during infusion is recommended. A woman who took both desmopressin and ibuprofen was found in a comatose state. Gently breathe in through the nose and out through the mouth several times.Wipe the nasal applicator using a clean tissue and replace the cap on the bottle.To avoid the spread of infection, do not use the container for more than 1 person.Do not co-administer with other intranasal products.Discard nasal spray 60 days after opening. Conversion from IV to PO may reduce the need for IV access, which carries a higher risk of hospital-acquired bloodstream infections, 4 phlebitis, cellulitis, and severe adverse events associated with infiltration5 for the patient. A woman who took both desmopressin and ibuprofen was found in a comatose state. Of course, hypertonic bicarbonate could also be used, as discussed last week. It is postulated that desmopressin-induced increases in FVIII and vWF are mediated through low-affinity, extrarenal V2 receptors. IV infusion . 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 .gov means its official. For All Patients Receiving Repeated Doses: Patients changing from intranasal desmopressin: We comply with the HONcode standard for trustworthy health information. -, BJU Int. Ketorolac (Toradol) Fluticasone; Umeclidinium; Vilanterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Cisplatin: (Moderate) Frequently monitor serum sodium levels if concurrent use of desmopressin and cisplatin is necessary. The initial response is reproducible if desmopressin is given every 2 to 3 days. Caution should be used when coadministering these agents. You can adjust the side column for all the news articles in the 'side column' tab above The frequency of dosing varies with patient responses. If used preoperatively, administer 2 hours before surgery. e-N;CM_[9,jPUO'@O%W]I,7wO;~ -O{GOiZb]]qJy=q4/I3>1&p#!EoA2hF"H kn.u,yQg 27.7 mcg sublingually once daily, 1 hour before bedtime without water. Missed Dose NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. 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. Factors associated with mortality of myxedema coma: report of eight cases and literature survey. doi: 10.1136/tsaco-2021-000852. Some have suggested an initial dosage range of 0.1 to 1 mcg in 1 or 2 divided doses. Last updated on Sep 28, 2022. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Infants 3 months of age and children: DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. Rapid IV bolus 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. 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. 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. Carbetapentane; 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. Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Monitor serum sodium concentrations within 1 week and then approximately 1 month after treatment initiation and periodically thereafter. . Infants 3 months of age and children: In hemophilia A and von Willebrand disease, it should only be used for mild to moderate cases. All Rights Reserved. administration route. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Single-dose administration has been used for uremic bleeding in patients with renal failure; however, repeat doses are not recommended. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Acetaminophen; 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. Intranasal RouteApproximately 3% to 4% of an intranasally administered dose is absorbed across the nasal mucosa. Immune Checkpoint Inhibitors as a Threat to the Hypothalamus-Pituitary Axis: A Completed Puzzle. 100 unit / 100 ml (1 unit/ml). Child 2-11 years In additio The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. how do you switch from labetalol IV to PO. Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. ea1`-@te3;plr*5L%5Ko=UNed If Desmopressin Acetate Injection 4 mcg/mL is used preoperatively, it should be administered 30 minutes prior to the scheduled procedure. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. [61810], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. The plasma concentrations generally declined below 2 pg/mL (lower limit of quantitation) 4 to 6 hours post-dose. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day.
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