150 mcg into each nostril once for a total dose of 300 mcg. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. Indications and dose Diabetes insipidus, treatment By mouth Child 1-23 months Initially 10 micrograms 2-3 times a day, adjusted according to response; usual dose 30-150 micrograms daily. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Fill in the blank - Do not enter the label - Rounding - Verify answer - Conversions - Practice questions. It acts on the kidneys to reduce the flow of urine. What is the standard conversion technique to calculate those dosages from a typical. Saint-Prex, Switzerland - 21 June, 2022 - Minirin (desmopressin) Nasal Spray 0.1 mg/ml room temperature stable (RTS)/ Octostim (desmopressin) Nasal Spray 1.5 mg/ml/ DDAVP (desmopressin acetate, 10 mcg/0.1 mL)/ Stimate (desmopressin acetate, 1.5 mg/1 mL) Nasal Spray/ Generic Desmopressin Acetate (10 mcg/0.1mL) Nasal Spray - Recall and Production Hold Statement If the product has not been used for a period of 1 week, re-prime the pump by pressing once.Instruct patient on the proper technique for administering the nasal spray. Desmopressin Intranasal (Noctiva, low dose) Each spray delivers 0.83 to 1.66 mcg Marketed for Nocturia in adults (but other non-medication approaches are preferred) Expensive: $425/month in 2018 Desmopressin Oral Initial: 0.2 mg PO qhs Use lowest effective dose Increase as needed to 0.6 mg at bedtime VII. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. If used preoperatively, administer 30 minutes before surgery. It is not known whether antibodies to desmopressin injection are produced after repeated injections. Initially, 0.05 mg PO twice daily. more than 50 kg: 150 mcg in each nostril. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. In addition, in vitro studies with human placenta demonstrate poor placental transfer of desmopressin. The recommended maintenance dose is 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. Guardrail Drug Requires documentation of two (2) RN's for double-checking. There is no information on the effects of desmopressin on the breast-fed infant or on milk production. Oral bioavailability: the amount of drug that enters systemic circulation when that drug is consumed orally. Azilsartan; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Desmopressin is in a class of medications called hormones. Amlodipine; Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Vasopressin also causes constriction of vascular smooth muscle and contraction of smooth muscle in the GI tract and uterus. Copyright 1993-2021 Repeat administration should be determined by laboratory response and clinical condition of the patient. Closely monitor serum sodium levels and urine output; fluid restriction is recommended. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. Dose range is 0.1 to 0.8 mg daily. Unauthorized use of these marks is strictly prohibited. 6 years or older: anaphylactoid reactions / Rapid / 0-1.0anaphylactic shock / Rapid / 0-1.0seizures / Delayed / Incidence not knownwater intoxication / Delayed / Incidence not knowncoma / Early / Incidence not knownthrombosis / Delayed / Incidence not knownthromboembolism / Delayed / Incidence not knownstroke / Early / Incidence not knownmyocardial infarction / Delayed / Incidence not known, hyponatremia / Delayed / 0.9-12.0hypertension / Early / 1.7-2.6photophobia / Early / 0-2.0conjunctivitis / Delayed / 0-2.0confusion / Early / Incidence not knownelevated hepatic enzymes / Delayed / Incidence not knownhypotension / Rapid / Incidence not knownsinus tachycardia / Rapid / Incidence not knownpalpitations / Early / Incidence not knowninfertility / Delayed / Incidence not knownbalanitis / Delayed / Incidence not knowntolerance / Delayed / Incidence not known, xerostomia / Early / 0-14.0rhinitis / Early / 3.0-8.0headache / Early / 2.0-5.0pharyngitis / Delayed / 2.3-3.8dizziness / Early / 0-3.0epistaxis / Delayed / 2.0-3.0nasal congestion / Early / 1.4-2.9sneezing / Early / 2.3-2.6back pain / Delayed / 1.1-2.3chills / Rapid / 0-2.0asthenia / Delayed / 0-2.0rhinalgia / Early / 2.0-2.0ocular pruritus / Rapid / 0-2.0lacrimation / Early / 0-2.0diarrhea / Early / Incidence not knownabdominal pain / Early / Incidence not knowndyspepsia / Early / Incidence not knownnausea / Early / Incidence not knownlethargy / Early / Incidence not knownflushing / Rapid / Incidence not knowncough / Delayed / Incidence not knowninjection site reaction / Rapid / Incidence not knownoligospermia / Delayed / Incidence not known. Plasminogen activator activity increases after intravenous desmopressin, but clinically significant fibrinolysis has not been detected in patients treated with desmopressin. A woman who took both desmopressin and ibuprofen was found in a comatose state. Tilt bottle so that the tube inside the bottle draws from the deepest portion of the medication.If given preoperatively, intranasal desmopressin should be administered 2 hours before surgery.To avoid the spread of infection, do not use the container for more than 1 person.Discard spray pump after 25 sprays since the amount delivered thereafter per spray may be substantially less than the recommended dose. administer single spray (150 mcg) if patient >12 years of age but <50 kg body weight. This site needs JavaScript to work properly. David McAuley, Pharm.D. In a male subject with mild Von Willebrand (vW) disease, intravenous infusion of DDAVP 2 hours after administration of oral tolvaptan did not produce the expected increases in vW Factor Antigen or Factor VIII activity. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fludrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. eCollection 2022. In certain clinical situations, it may be justified to try desmopressin in persons with factor VIII concentrations of 2% to 5%; however, carefully monitor these patients. When switching from DDAVP Nasal Spray to DDAVP Injection, the starting dose is one-tenth times the DDAVP Nasal Spray dose. Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. IV: 100 mg IV bolus given immediately, followed by 25 to 75 mg IV every 6 hours or 200 mg/24 hours as a continuous IV infusion for the first 24 hours. Bookshelf The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Sumatriptan; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Vincristine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Valdecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Disclaimer. Subcutaneously: 1 to 2 mcg twice a day Example: Ampicillin-sulbactam 1.5gm IV Q6H to amoxicillin-clavulanic acid 875mg/125mg PO Q12H. Losartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. hydromorphone dose conversion. Desmopressin is contraindicated in patients with moderate to severe renal impairment (e.g., CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2). Maintenance dose range: 10 mcg/day to 30 mcg/day intranasally (0.1 mL/day to 0.3 mL/day) in 1 to 2 divided doses. If used to reduce spontaneous or traumatic bleeding, doses may be repeated after 8 hours to 12 hours and once daily thereafter, if needed, based upon clinical condition and von Willebrand factor and factor VIII levels. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. DDAVP (Desmopressin Acetate Tablets) may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. Wirtz MR, Roelofs JJ, Goslings JC, Juffermans NP. 0.1 to 0.4 mL via rhinal tube intranasally twice a day. Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. Blood samples were taken before and at predetermined time points up to 12 h after dosing. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. documenting the conversion using the "IV to PO conversion" category. Idiopathic partial central diabetes insipidus. Persons with vWD subtype 1C, which is characterized by a shorted vWF half-life, may require alternative management in the setting of surgery. On Day 7, 6 subjects were given a single SC bolus injection of desmopressin. Selective serotonin reuptake inhibitors: (Minor) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including SSRIs. Caution should be used when coadministering these agents. IV: 0.3 mcg/kg once slowly over 15-30 minutes. DDAVP Nasal Spray (desmopressin acetate) Rx only DESCRIPTION DDAVP Nasal Spray (desmopressin acetate) is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin (ADH), an antidiuretic hormone affecting renal water conservation. Desmopressin is not effective in persons with type 3 von Willebrand's disease (vWD) and can cause platelet aggregation, thrombocytopenia, and possibly thrombosis in persons with type 2B vWD. Ther Drug Monit. IV: 1 to 2 mcg twice a day ea1`-@te3;plr*5L%5Ko=UNed Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. Find medical information for DDAVP on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. However, desmopressin is used off-label as a single injection for uremic bleeding in persons with renal failure. Bioavailability and pharmacokinetics of desmopressin in elderly men. A woman who took both desmopressin and ibuprofen was found in a comatose state. Einstein (Sao Paulo). Conversion of IV Midazolam. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> Methods: The effect of DDAVP was measured on F VIII/vWF complex and on plasminogen activator release. This places the solution in the nasal cavity and not down your throat.After use, reseal the dropper tip and close the bottle. If administered more than once a day, adjust for an adequate diurnal rhythm of urine output. Adjust doses based on patient's diurnal pattern of response. Prepare the solution for infusion using aseptic technique. For continuous infusions, conc. The mean (95% CI) AUC at night was 302 (272-335) pg x h/ml and in the day was 281 (253-312) pg x h/ml. Desmopressin in nocturnal enuresis 677,ug given intranasally wasequivalent to 400[ig given orally.8 Wedecidedto comparethe 20 igintranasal dose with the 200 tg oral dose, whichwefoundin a pilot study to be as effective as a 400 ptg dose, but with less effect on serum electrolytes and body weight. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. CAREFULLY BEFORE ACCESSING OR USING THIS SITE. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. Desmopressin is a strong V2 agonist and has no effect on V1 receptors. Vincristine Liposomal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Meclofenamate Sodium: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. A woman who took both desmopressin and ibuprofen was found in a comatose state. The resultant increases in FVIII and vWF are similar to those seen with replacement therapy using blood products. Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. Carbetapentane; Phenylephrine; Pyrilamine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. The plasma concentrations generally declined below 2 pg/mL (lower limit of quantitation) 4 to 6 hours post-dose. celebrity wifi packages cost. Generic:- Closed containers will maintain stability for 3 weeks at controlled room temperature (68 to 77 degrees F)- Refrigerate (between 36 and 46 degrees F)DDAVP:- Discard product if it contains particulate matter, is cloudy, or discolored- Store in refrigerator at 2 to 8 degrees C (36 to 46 degrees F)Minirin:- Store at 77 degrees F; excursions permitted to 59-86 degrees F- Store uprightNocdurna:- Product should always be stored in the blister and only removed immediately before use- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in the original carton to protect from lightNoctiva:- Product must be used within 60 days after removal from refrigeration to room temperature (77 degrees F)- Store in refrigerator (36 to 46 degrees F), excursions permitted between 32 to 59 degrees F- Store uprightStimate:- Store at room temperature (up to 77 degrees F)- Store upright. Propranolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Commonly central DI is treated with desmopressin. once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Candesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. During the initial titration period and continued therapy, observe and monitor closely; treatment should be adjusted according to the diurnal pattern of response. 14 A commonly cited double-blind trial suggests a conversion of 1 mg IV lorazepam to 2 mg of IV midazolam, which is further supported using a midazolam oral bioavailability of 40% due to a . Only start or resume therapy in patients with a normal serum sodium concentration. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. DDAVP (2 micrograms IV q8hr) is started immediately and continued until the sodium is close to normal. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. *L#n~i V3{kf_t.wjO_KgImL%4+GJ+Pp QsWAd._e7p!90&z {c`Kk;swZ/Nf{s~d? If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. TYPES OF IV TO PO THERAPY CONVERSIONS: There are three types of IV to PO therapy conversions as defi ned below: SEQUENTIAL THERAPY SWITCH THERAPY STEP DOWN THERAPY. 2022 Mar 2;12(3):389. doi: 10.3390/biom12030389. Desmopressin is similar to a hormone that is produced in the body. No statistically significant differences were detected between night and day except for terminal half-life, which was 3.1 h at night and 2.8 h in the daytime (P=0.02). The pump will stay primed for up to 1 week. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin is administered intravenously or subcutaneously.Desmopressin (DDAVP) injection has an antidiuretic hormone activity of 16 International Units/mL; 1 mcg desmopressin is equivalent to 4 International Units antidiuretic hormone activity.If given preoperatively, desmopressin injection should be given 30 minutes before the scheduled procedure.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Atenolol; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 1 0 obj During the initial titration period and continued therapy, observe and monitor closely. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of . DDAVP Rhinal TubeDDAVP Rhinal tube is used to administer desmopressin doses less than 10 mcg (less than 0.1 mL).Break the seal on the bottle and remove cap. What is the difference in Nocdurna dosage between men and women. Flunisolide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin works by limiting the amount of water passed in the urine. Infants 3 months of age and children: Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. A woman who took both desmopressin and ibuprofen was found in a comatose state. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. peak plasma concentration (Cmax) was 4 (+/- 3.85) pg/mL for the 0.83 mcg dose and 9.11 (+/- 6.90) pg/mL for the 1.66 mcg dose. KEEP REFRIGERATED AT 2 to 8C (36 to 46F). In this study, efficacy and side effects of oral desmopressin. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. LV>T6If7>LYJTgJ^kyf>[7Sz]>mCh^3r3a2Lmm$9_5y/;D|s }3a7+NGv46p?MISiZ?dV?pmSosEIN.6DLY}%OL!+Cuf^C;\EvwgOv|2> V,>1w|>>O[[ej,UdSg,ufiEI'&c3Y_$x_'Ifm9s;KY|{AuLTiv[V>n~>r`-@Z(^++Gj~Stsz|6jmm/1dEIz$+ZE7c0rw@GRt=%K2*#g`9'Jp?Hol+c/1K6//1-=d#~t*8t)~H0E>ue)'U'$L Preoperative doses may be given 2 hours prior to the scheduled procedure. Desmopressin acetate 100 microgram Tablet Active Ingredient: desmopressin acetate Company: Aspire Pharma Ltd See contact details ATC code: H01BA02 About Medicine Prescription only medicine Healthcare Professionals (SmPC) Patient Leaflet (PIL) This information is for use by healthcare professionals Last updated on emc: 02 Mar 2022 Quick Links For a patient requiring volume resuscitation, a large volume of normal saline could be . Dependent on route of administration and indication for therapy. Despite low bioavailability, the pharmacodynamic effects of oral desmopressin were similar in magnitude to those after intravenous dose at night and during the first 6 h after daytime administration. [33605], Initially, 10 mcg (0.1 mL) intranasally into 1 nostril, may increase to 30 mcg until the patient can sleep for an adequate period of time without incidence of polyuria. After at least 7 days of treatment, the dose may be increased to 1.66 mcg, if needed, provided the serum sodium is within the normal range during treatment with the 0.83 mcg dose. A woman who took both desmopressin and ibuprofen was found in a comatose state. The tendency toward tachyphylaxis (lessening of response) with repeated administration given more frequently than every 48 hours should be considered in treating each patient. 1 to 2 mcg subcutaneously twice a day or As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Applies to the following strengths: 0.15 mg/inh; 10 mcg/inh; 4 mcg/mL; 0.1 mg; 0.2 mg; 15 mcg/mL; 0.01%; 27.7 mcg; 55.3 mcg; 0.83 mcg/0.1 mL; 1.66 mcg/0.1 mL; 15 mcg/inh. Oral TabletsIf converting from intranasal therapy, administer oral dose 12 hours after last intranasal dose.Patient response to each dose should be determined by adequate duration of sleep and adequate, not excessive, water turnover. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). A woman who took both desmopressin and ibuprofen was found in a comatose state. Intranasal: 5 to 40 mcg/day divided into 1 to 3 doses. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Brompheniramine; Carbetapentane; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Hydrochlorothiazide, HCTZ; Moexipril: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Pharmacokinetic parameters were derived using a two-compartmental model except for AUC(0-->t), which was derived using non-compartmental analysis. Oral doses of 0.2 and 0.4 mg produce similar responses on urine volume and urine osmolality as 0.01 mg and 0.02 mg intranasal doses. Desmopressin is also used to control bed-wetting. A woman who took both desmopressin and ibuprofen was found in a comatose state. When switching between formulations, the below text is meant as guidance for starting dose. Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. The mean (+/- S.D.) Budesonide; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. This increase is dose-dependent, with an IV dosage of 0.4 mcg/kg producing a 300% to 400% maximum increase in Factor VIII activity. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Select one or more newsletters to continue. A woman who took both desmopressin and ibuprofen was found in a comatose state. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. Renal concentration capacity testing in children below the age of 1 year should only be performed under carefully supervised conditions in hospital. IV infusion . IV Push for Hyperkalemia. As of 2007 the intranasal formulation is no longer FDA-approved for the treatment of primary nocturnal enuresis secondary to postmarketing reports of hyponatremia-related seizures, which most often occurred in children using the intranasal formulation. Doses may be titrated up to 0.6 mg PO once daily at bedtime, depending on individual patient response. Every 3 months, Careers. {+/7VPerb}6Wz+>8. <> Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin nasal sprays may not be substituted for each other due to significant differences in concentration.