From the FDA Drug Label
DOSAGE AND ADMINISTRATION Hemophilia A and von Willebrand’s Disease (Type I): Desmopressin acetate injection 4 mcg/mL is administered as an intravenous infusion at a dose of 0. 3 mcg desmopressin acetate/kg body weight The usual dosage range in adults is 0. 5 mL (2 mcg) to 1 mL (4 mcg) daily, administered intravenously or subcutaneously, usually in two divided doses.
The maximum dose of Desmopressin in adults is not explicitly stated in the drug label. However, based on the dosage range provided for Diabetes Insipidus, the maximum dose is 4 mcg daily, administered intravenously or subcutaneously, usually in two divided doses 1. For Hemophilia A and von Willebrand’s Disease (Type I), the dose is 0.3 mcg desmopressin acetate/kg body weight, but the maximum dose is not specified 1.
From the Research
The maximum dose of desmopressin for adults is 0.6 mg orally or 40 mcg intranasally for primary nocturnal enuresis, and 0.3 mcg/kg intravenously for hemophilia A or von Willebrand disease, with careful monitoring for hyponatremia and fluid restriction to prevent water intoxication 2. The maximum dose of desmopressin varies by formulation and indication.
- For central diabetes insipidus, the maximum oral tablet dose is typically 1.2 mg daily (divided into 2-3 doses), while the maximum intranasal solution dose is 40 mcg daily (divided into 1-3 doses) 3.
- For primary nocturnal enuresis, the maximum oral dose is 0.6 mg at bedtime, and for intranasal spray, it's 40 mcg at bedtime 4.
- For hemophilia A or von Willebrand disease, the maximum intravenous dose is 0.3 mcg/kg per dose 3. Patients should be monitored for hyponatremia, especially with higher doses, as desmopressin works by increasing water reabsorption in the kidneys 2.
- Fluid intake should be restricted during treatment to prevent water intoxication.
- Dose adjustments may be necessary for elderly patients or those with renal impairment, and the lowest effective dose should always be used to minimize adverse effects 2. The most recent and highest quality study, published in 2018, recommends a minimum dosage of 25 μg orally disintegrating sublingual desmopressin for women and 50 μg for men for the treatment of nocturia, with careful assessment to identify the appropriate and safest treatment in each patient 2.