DESMOPRESSIN ACETATE
(DDAVP, Octostim)Standard Prescription
Diabetes Insipidus
desmopressin__mg PO Q__H
desmopressin__mcg intranasal Q__H
desmopressin__mcg SC/IV Q__H
Nocturnal Enuresis
desmopressin__mg PO QHS
Hemophilila A / von Willebrand's Disease Type I
desmopressin__mcg (__mg/kg/dose) IV/SC __minutes prior to procedure
desmopressin__mg PO Q__H
desmopressin__mcg intranasal Q__H
desmopressin__mcg SC/IV Q__H
Nocturnal Enuresis
desmopressin__mg PO QHS
Hemophilila A / von Willebrand's Disease Type I
desmopressin__mcg (__mg/kg/dose) IV/SC __minutes prior to procedure
Dosages
Diabetes Insipidus Oral:
SL melts: 120 mcg SL at HS, then titrate to desired effect to a maximum of 360 mcg/dose
< 2 yr: start with 0.025 mg/dose PO once daily and titrate to effect.
2-12 yr: Start with 0.05 mg/dose PO BID; titrate to effect (usual dose range: 0.1-0.8 mg/24hr PO div. BID to TID).
> 12 yr and adult: Start with 0.05 mg/dose PO BID; titrate dose to effect (usual dose range: 0.1 -1.2 mg/24hr PO div. BID to TID).
Diabetes Insipidus Intranasal:
< 2 yr: start with 1.25 mcg daily; titrate to effect. May need BID to TID dosing. 2 to 12 yr: start with 2.5 mcg daily; titrate to effect. May need BID to TID dosing.> 12 yr: Start with 5 mcg daily; titrate to effect. May need BID to TID dosing.
Diabetes Insipidus IV/SC:
generally 1/10 of the intranasal dose. Use 15 mcg/mL concentration for SC doses:
< 2 yr: start with 0.15 mcg (1 unit with an insulin syringe) daily; titrate to effect. May need BID to TID dosing
2 to 12 yr: start with 0.3 mcg (2 units with an insulin syringe) daily; titrate to effect. May need BID to TID dosing
> 12 yr: Start with 0.45 mcg (3 units with an insulin syringe) daily; titrate to effect. May need BID to TID dosing
< 2 yr: start with 0.15 mcg (1 unit with an insulin syringe) daily; titrate to effect. May need BID to TID dosing
2 to 12 yr: start with 0.3 mcg (2 units with an insulin syringe) daily; titrate to effect. May need BID to TID dosing
> 12 yr: Start with 0.45 mcg (3 units with an insulin syringe) daily; titrate to effect. May need BID to TID dosing
Hemophilia A and von Willebrand's Disease Type I:
Children: 0.3 mcg/kg/dose by IV infusion or SC ( 30-60 min. prior to procedure). Max 20 mcg/dose.
Nocturnal Enuresis (>= 6 yr):
Oral: initial: 0.2 mg/dose PO at HS, then titrate to desired effect to a maximum of 0.6 mg/dose.SL melts: 120 mcg SL at HS, then titrate to desired effect to a maximum of 360 mcg/dose
Mechanism of Action
Synthetic vasopressin analogue; hemostatic agent
Forms Supplied
injection: 4 mcg/mL (DDAVP), 15 mcg/mL (Octostim).
nasal spray: 10 mcg/spray.
tablet: 0.1 mg (100 mcg), 0.2 mg (200 mcg)
Comments
Dose must be individualized; adjust fluid intake to avoid water intoxication
Caution in hypertension and coronary artery disease
May cause headache, nausea, hyponatremia, nasal congestion, abdominal cramps and hypertension
Parenteral dose is approximately 10% of the intranasal dose.
Oral dose is 10-20 times higher than the established intranasal dose
Peak effects: 1-5 hr with intranasal; 1.5-3 hr with IV route; 2-7 hr with PO route
Duration of effect is 8-12 hr.
For intranasal doses less than 0.0125 mL (1.25 mcg), use the injectable form intranasally.
For subcutaneous doses, use 15 mcg/mL concentration (Octostim) and an insulin syringe (1 unit = 0.15 mcg)
Intranasal desmopressin is contraindicated by Health Canada for primary nocturnal enuresis (PNE) due to risk of severe hyponatremia and seizures. Patients using desmopressin tablets for PNE should have their therapy interrupted during acute illnesses that may lead to fluid and/or electrolyte imbalance.
Avoid giving desmopressin for bleeding disorders in children less than 2 years of age (hematology consult required).
Caution in hypertension and coronary artery disease
May cause headache, nausea, hyponatremia, nasal congestion, abdominal cramps and hypertension
Parenteral dose is approximately 10% of the intranasal dose.
Oral dose is 10-20 times higher than the established intranasal dose
Peak effects: 1-5 hr with intranasal; 1.5-3 hr with IV route; 2-7 hr with PO route
Duration of effect is 8-12 hr.
For intranasal doses less than 0.0125 mL (1.25 mcg), use the injectable form intranasally.
For subcutaneous doses, use 15 mcg/mL concentration (Octostim) and an insulin syringe (1 unit = 0.15 mcg)
Intranasal desmopressin is contraindicated by Health Canada for primary nocturnal enuresis (PNE) due to risk of severe hyponatremia and seizures. Patients using desmopressin tablets for PNE should have their therapy interrupted during acute illnesses that may lead to fluid and/or electrolyte imbalance.
Avoid giving desmopressin for bleeding disorders in children less than 2 years of age (hematology consult required).
References
1, 4, 32, 44, 148
Last Edited
2021-11-13 06:12:05