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What is DDAVP?

DDAVP is a drug used to treat diabetes insipidus, enuresis, bedwetting problems and certain bleeding disorders. The active substance, desmopressin, is a synthetic analogue of vasopressin. The use of DDAVP leads to a decrease in the frequency of urination and a decrease in nighttime polyuria.

How does it work?

Desmopressin (compared with the endogenous hormone) has a less pronounced effect on the smooth muscle congestion and internal organs but at the same time a stronger effect on diuresis. Desmopressin improves the permeability of the epithelial layer of the distal renal tubules of water, which increases its reabsorption. When using the drug in the treatment of patients with non-sugar diabetes of central origin, it reduces the volume of urine and increases its osmolarity, which leads to a decrease in the frequency of urination and the elimination of nighttime polyuria. The greatest antidiuretic effect of the drug is observed 4 or 7 hours after administration.

How should I use DDAVP?

The drug is taken orally. The optimal dose is adjusted individually. The drug should be taken some time after a meal, as a meal can influence the drug absorption and its effectiveness.

  • Central diabetes insipidus: the initial dose for children and adults – 0.1 mg 1-3 times a day, subsequently the dose is adjusted depending on the response – from 0.2 to 1.2 mg/day. For most patients, the optimal dose is 0.1-0.2 mg 1-3 times a day;
  • Primary nocturnal enuresis: the initial dose is 0.2 mg at night; if ineffective, the dose is increased to 0.4 mg. The recommended course is 3 months;
  • Nighttime polyuria in adults: the initial dose is 0.1 mg at night, if ineffective after 1 week, the dose can be increased to 0.2 mg and further, with a weekly increase. If a positive effect is not observed after 4 weeks, it is recommended to cancel the medication.

What are the contraindications of this medicine?

Do not use DDAVP in the presence of any of the following conditions:

  • hypersensitivity (allergy) to one of the components of the drug;
  • congenital polydipsia (unquenchable thirst);
  • psychogenic polydipsia;
  • heart failure;
  • other conditions that require diuretic administration;
  • moderate renal failure;
  • severe renal failure (with creatinine clearance lower than 50 ml per minute).

What are the side effects of DDAVP?

Therapy with this drug can cause the following adverse reactions:

  • fluid retention;
  • hyponatremia;
  • increase in pressure, tides;
  • headache, convulsions;
  • rhinitis, nosebleeds;
  • dry throat;
  • nausea, vomiting, abdominal pain;
  • pain in the vulva;
  • dysuria;
  • increased sweating;
  • weight gain;
  • emotional disorders (in childhood).

If you notice any unusual side effects after taking the medication, you should contact your doctor and discuss possible changes to the treatment regimen.

What may interact with this medicine?

Do not take DDAVP tablets if you are currently using any of the following medications:

  • indomethacin;
  • glyburide;
  • tetracycline;
  • lithium preparations;
  • norepinephrine;
  • hypertensive agents;
  • tricyclic antidepressants;
  • selective serotonin inhibitors;
  • chlorpromazine;
  • carbamazepine;
  • nonsteroidal anti-inflammatory drugs;
  • loperamide;
  • dimethicone.

What should I watch for while using this medicine?

Overdose symptoms: plasma hypo-osmolarity, water intoxication, seizures and other neurological and mental symptoms. In case of an overdose, the drug should be canceled, the intake of fluids should be limited.

Caution must be exercised when using DDAVP during pregnancy and breastfeeding.

To avoid side effects, it is necessary to limit the intake of fluid 1 hour before use and within 8 hours after using the drug in patients with primary nocturnal enuresis. Treatment without restriction of fluid intake can lead to fluid retention in the body and hyponatremia.

The drug should not be used if the presence of other additional causes for fluid retention. The risk of side effects is increased in elderly patients and in patients with initially low plasma sodium and polyuria.

To prevent hyponatremia, a patient should increase the frequency of determining the concentration of sodium in the blood plasma, especially when used simultaneously with drugs that cause the syndrome of inadequate secretion of antidiuretic hormone (including tricyclic antidepressants, selective serotonin inhibitors, chlorpromazine and carbamazepine) and NSAIDs.

Acute urinary incontinence, dysuria and/or nocturia, decompensated diabetes mellitus, urinary tract infection, a suspected bladder or prostate gland tumor, polydipsia should be diagnosed before treatment with DDAVP.