Desmopressin Acetate (1-Deamino-8-D-Arginine Vasopressin)(des moe press’ in)
Apo-Desmopressin (CAN), DDAVP, Octostim (CAN), Stimate, Stimate Nasal Spray
PREGNANCY CATEGORY B
Drug Classes
Hormone
Therapeutic Actions
Synthetic analogue of human ADH; promotes resorption of water in the renal tubule; increases levels of clotting factor VIII.
Indications
DDAVP: Neurogenic diabetes insipidus (not nephrogenic in origin; intranasal and parenteral); hemophilia A (with factor VIII levels exceeding 5%; parenteral); von Willebrand disease (type I; parenteral or intranasal)
Stimate: Treatment of hemophilia A (with factor VIII levels exceeding 5%), von Willebrand disease (type I)
Unlabeled use (intranasal): Treatment of chronic autonomic failure
Contraindications and Cautions
Contraindicated with allergy to desmopressin acetate; type II von Willebrand disease; severe renal impairment
Use cautiously with vascular disease or hypertension, lactation, water intoxication, fluid and electrolyte imbalance, pregnancy.
Available Forms
Tablets—0.1, 0.2 mg; nasal solution—0.1 mg/mL, 1.5 mg/mL; injection—4 mcg/mL
Dosages
Adults
Diabetes insipidus: 0.1–0.4 mL/day intranasally as a single dose or divided into two to three doses; 0.5–1 mL/day subcutaneously or IV, divided into two doses, adjusted to achieve a diurnal water turnover pattern, or 0.05 mg PO bid—adjust according to water turnover pattern.
Hemophilia A or von Willebrand disease: 0.3 mcg/kg diluted in 50 mL sterile physiologic saline; infuse IV slowly over 15–30 min. If needed preoperatively, infuse 30 min before the procedure. Determine need for repeated administration based on patient response. Intranasal—1 spray per nostril, 2 hr preoperatively for a total dose of 300 mcg.
Pediatric patients
Diabetes insipidus: For patients 3 mo–12 yr, 0.05–0.3 mL/day intranasally as a single dose or divided into two doses; or 0.05 mg PO daily—adjust according to water turnover pattern.
Hemophilia A or von Willebrand disease: For patients 11 mo and older, one spray per nostril (150 mcg), total dose 300 mcg; weighing less than 50 kg, 150 mcg as a single spray.
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