What is the use of DDAVP (Desmopressin)?

From the Guidelines

DDAVP (desmopressin) is a synthetic analog of vasopressin used primarily to treat diabetes insipidus, nocturnal enuresis (bedwetting), and certain bleeding disorders, with a recommended dose of 0.2-0.6 mg orally at bedtime for nocturnal enuresis in children, as supported by grade Ia evidence 1. The use of DDAVP for nocturnal enuresis is based on its ability to decrease urine production at night, with studies showing that 30% of children with enuresis are full responders and 40% have a partial response to the treatment 1. Key considerations for the use of DDAVP include:

• Restricting water intake during treatment to prevent hyponatremia, especially in children and elderly patients 1
• Monitoring for fluid retention and electrolyte imbalances, particularly with repeated doses 1
• Avoiding the use of DDAVP in patients with polydipsia, as it can cause water intoxication with hyponatremia and convulsions 1
• Preferring oral formulations over nasal sprays due to the higher risk of complications associated with the latter 1
• Considering the use of DDAVP in combination with other treatments, such as alarm therapy or sustained-release anticholinergic agents, for optimal results 1 Overall, DDAVP is a safe and effective treatment for nocturnal enuresis, with a low risk of side effects and a high success rate, making it a valuable option for patients with this condition, as supported by the most recent and highest quality study 1.

From the FDA Drug Label

Desmopressin Acetate Injection is a vasopressin analog used for: Central Diabetes Insipidus - 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. Hemophilia A- for patients with factor VIII coagulant activity levels greater than 5% to maintain hemostasis during surgical procedures and postoperatively or reduce bleeding with episodes of spontaneous or traumatic injuries such as hemarthroses, intramuscular hematomas, or mucosal bleeding. von Willebrand's disease (Type I) - for patients with mild to moderate disease with factor VIII levels greater than 5% to maintain hemostasis during surgical procedures or traumatic injuries such as hemarthroses, intramuscular hematomas, or mucosal bleeding.

The use of DDAVP (Desmopressin) is for the treatment of:

• Central Diabetes Insipidus
• Hemophilia A
• von Willebrand's disease (Type I) 2

From the Research

Uses of DDAVP

• DDAVP (Desmopressin) is typically prescribed for:
  • Central diabetes insipidus 3, 4, 5
  • Von Willebrand's disease 3, 6
  • Nocturnal enuresis (bedwetting) 3, 6, 7
  • Polyuria and nocturia 4, 5
  • Bleeding disorders, such as hemophilia 6
  • Diagnostic urine concentration testing 7

Common Adverse Reactions

• The primary adverse reaction associated with DDAVP is hypotonic hyponatremia (low sodium levels in the blood) 3, 6, 7, 4, 5
• Severe hyponatremia can lead to seizures, brain damage, and even death 3, 6, 7, 4, 5
• Other symptoms of hyponatremia include nausea, vomiting, headache, fatigue, dizziness, weakness, and decreased concentration 7, 5

Special Considerations

• Younger children are at greater risk for water intoxication (hyponatremia) than older children 7
• The risk of hyponatremia is particularly high at the beginning of DDAVP therapy 7
• Patients with prodromal symptoms such as nausea, vomiting, and headaches are at increased risk of developing severe hyponatremia 7