From the FDA Drug Label
Desmopressin acetate is a replacement hormone for antidiuretic hormone in the treatment of central diabetes insipidus The antidiuretic effects of desmopressin acetate are mediated by stimulation of vasopressin 2 (V2) receptors, thereby increasing water re-absorption in the kidney, and hence reducing urine production Desmopressin acetate injection 4 mcg/mL is indicated as antidiuretic replacement therapy in the management of central (cranial) diabetes insipidus
Desmopressin is used to treat central diabetes insipidus by replacing the antidiuretic hormone and reducing urine production.
- It works by stimulating vasopressin 2 (V2) receptors in the kidney to increase water reabsorption.
- Desmopressin acetate injection is indicated for the management of central diabetes insipidus 1, 2, 1.
From the Research
DDAVP (desmopressin) is the first-line treatment for central diabetes insipidus, with oral administration being a reliable and effective mode of treatment, as evidenced by the most recent study 3. The typical starting dose of oral desmopressin is 0.1-0.4 mg twice daily, which can be titrated based on symptom control and serum sodium levels.
- Key considerations in treatment include:
- Controlling polyuria while avoiding hyponatremia
- Monitoring fluid intake, urine output, and watching for symptoms of water intoxication
- Adjusting treatment to maintain eunatremic weight and guide day-to-day fluid targets
- Allowing regular breaks from DDAVP to prevent hyponatremia, as recommended in the most recent study 3
- The mechanism of action of DDAVP involves binding to V2 receptors in the kidney collecting ducts, increasing water reabsorption by upregulating aquaporin-2 water channels, effectively replacing the deficient hormone in central diabetes insipidus, as described in earlier studies 4, 5, 6, 7.
- The most recent study 3 highlights the importance of oral DDAVP as a reliable mode of treatment for chronic central diabetes insipidus, replacing nasal DDAVP, and emphasizes the need for careful management to avoid hyponatremia and hypernatraemia.