From the Guidelines
Desmopressin is indicated for the treatment of central diabetes insipidus, nocturnal enuresis, and hemophilia A and von Willebrand's disease.
Key Indications
- Central Diabetes Insipidus: Desmopressin is used to replace the anti-diuretic hormone (ADH) in patients with central diabetes insipidus, helping to regulate water balance in the body 1.
- Nocturnal Enuresis: Desmopressin is used to treat nocturnal enuresis (bedwetting) in children, with a typical dose of 20-40 micrograms intranasally at bedtime 1.
- Hemophilia A and von Willebrand's Disease: Desmopressin is used to increase the levels of factor VIII and von Willebrand factor in patients with hemophilia A and von Willebrand's disease, with a dose of 0.3 micrograms per kilogram intravenously 1.
Important Considerations
- Monitoring for Hyponatremia: Patients taking desmopressin should be monitored for signs of hyponatremia, such as headache, nausea, and vomiting, and the dose should be adjusted accordingly 1.
- Dose and Administration: The dose and administration of desmopressin vary depending on the condition being treated, and patients should be instructed on the proper use of the medication 1.
- Contraindications and Precautions: Desmopressin should be used with caution in patients with certain medical conditions, such as heart disease or renal impairment, and should not be used in patients with a history of hyponatremia or polydipsia 1.
From the FDA Drug Label
Hemophilia A: Desmopressin Acetate Injection 4 mcg/mL is indicated for patients with hemophilia A with factor VIII coagulant activity levels greater than 5%. von Willebrand’s Disease (Type I): Desmopressin acetate injection 4 mcg/mL is indicated for patients with mild to moderate classic von Willebrand’s disease (Type I) with factor VIII levels greater than 5% Diabetes Insipidus: Desmopressin acetate injection 4 mcg/mL is indicated as antidiuretic replacement therapy in the management of central (cranial) diabetes insipidus and for the management of the temporary polyuria and polydipsia following head trauma or surgery in the pituitary region.
The indications for desmopressin are:
- Hemophilia A with factor VIII coagulant activity levels greater than 5%
- Mild to moderate von Willebrand’s Disease (Type I) with factor VIII levels greater than 5%
- Central (cranial) diabetes insipidus
- Management of temporary polyuria and polydipsia following head trauma or surgery in the pituitary region 2
From the Research
Indications for Desmopressin
The indications for desmopressin (1-deamino-8-D-arginine vasopressin) include:
- Central diabetes insipidus 3, 4, 5, 6, 7
- Hemostatic disorders such as von Willebrand's disease 3, 4, 5, 6, 7
- Nocturnal enuresis 3, 4, 5, 6, 7
- Nocturnal polyuria leading to nocturia 6
- Mild hemophilia A 4, 6
- Uremic bleeding 6
- Dental extractions 6
- Epistaxis 6
- Menstrual bleeding 6
- Trauma resuscitation with active hemorrhage 6
- Avoiding rapid sodium correction along with hypertonic saline 6
- Management of intracranial bleed due to the use of antiplatelet agents 6
Key Points
- Desmopressin is a synthetic vasopressin analog with antidiuretic and hemostatic properties 3, 4, 5, 6, 7
- It is available for intranasal and parenteral administration 5
- The dose and formulation of desmopressin may vary depending on the indication and patient population 4, 5, 6
- Close monitoring is recommended when switching preparations or adjusting doses to minimize the risk of hyponatremia 4