What is this medication?
Desmopressin, DDAVP/Nocdurna (US/CDN)/Stimate (US)/Octostim (CDN)
Antihemophilic Agent; Hemostatic Agent; Synthetic Posterior Pituitary Hormone; Vasopressin Analog
Indicated for treatment of Diabetes Insipidus, Hemophilia A, Von Willebrand Disease (Type 1), Uremic Bleeding, Nocturia, Primary Nocturnal Enuresis
“ALERT: US Boxed Warning
Hyponatremia (Nocdurna, Noctiva nasal spray):
Desmopressin can cause hyponatremia. Severe hyponatremia can be life-threatening, leading to seizures, coma, respiratory arrest, or death. Desmopressin is contraindicated in patients at increased risk of severe hyponatremia, such as patients with excessive fluid intake, illnesses that can cause fluid or electrolyte imbalances, and in those using loop diuretics or systemic or inhaled glucocorticoids. Ensure serum sodium concentrations are normal before starting or resuming desmopressin. Measure serum sodium within 7 days and ~1 month after initiating therapy or increasing the dose and periodically during treatment. More frequently monitor serum sodium in patients ≥65 years of age and in patients at increased risk of hyponatremia. If hyponatremia occurs, desmopressin may need to be temporarily or permanently discontinued.”
How does this medication work?
Desmopressin, DDAVP/Nocdurna/Stimate/Octostim is a synthetic analogue of the antidiuretic hormone arginine vasopressin. Desmopressin increases cyclic adenosine monophosphate (cAMP) in renal tubular cells which increases water permeability resulting in decreased urine volume and increased urine osmolality. It also increases plasma levels of von Willebrand factor, factor VIII, and t-PA contributing to a shortened activated partial thromboplastin time (aPTT) and bleeding time.
How should I take this medication?
Refer to product monograph as dosing is complex and varies greatly with condition it is being used for. It is available in various preparations such as oral tablet, sublingual tablet, nasal spray, and injection.
How to Take:
Oral, tablet: May administer with or without food. Food may reduce/delay absorption although does not affect antidiuretic activity
Sublingual: Keep tablet under tongue until completely dissolved.
You Need to Avoid: Avoid excessive intake of water due to increased risk of hyponatremia. Fluid restrictions may be recommended depending on patient status and diagnosis.
What should I watch for while using this medication?
Before starting Desmopressin, DDAVP/Nocdurna/Stimate/Octostim make sure your physician is aware of any allergies and medications you currently take, if you have hyponatremia or a history of hyponatremia, cardiovascular disease, a history of polydipsia, are pregnant, or breastfeeding. Desmopressin has been associated with rare but serious side effects such as fluid retention, allergic reactions, extreme hyponatremia, hypotension, and thrombotic events. Patients with type 2B von Willebrand disease requiring hemostasis should not be treated with desmopressin since may result in platelet aggregation, thrombocytopenia, and possibly thrombosis.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Generally, well tolerated with the most common side effects being hyponatremia and xerostomia (dry mouth).
Note this is not a complete list of side effects for Desmopressin, DDAVP/Nocdurna/Stimate/Octostim only common ones.
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