Antidiuretic effect of desmopressin given in hemostatic dosages to healthy volunteers

Abstract

The aim of this study was to characterize the magnitude and duration of the antidiuretic effects elicited by desmopressin given in hemostatic dosage intravenously (i.v.) (0.3 μg/kg) or intranasally (i.n.) (300 μg) both as single or repeated doses (four i.n. doses with 12‐hr intervals) to healthy volunteers. Urine osmolality increased to a maximum median value of 1,087 mOsmol/kg after the single i.v. dose, 1,065 after the single i.n. dose, and 1,071 during the repeated i.n. dosing schedule, and did not differ significantly between the three dosage schedules. The increase lasted for 24 hr after single doses, and 12 hr after the last of the repeated i.n. doses. Serum sodium did not decrease more than normal diurnal variation after single doses, but decreased marginally below the normal reference range in three volunteers after repeated doses. Lowest median serum sodium concentrations after single i.v. and i.n. doses were 140 and 141 mmol/l, respectively, and 139 after repeated i.n. doses. Body weight changed only marginally after single doses, but increased 1.3 kg during repeated dosing. In adult healthy volunteers, single desmopressin doses give an antidiuretic effect lasting for about 24 hr. There is no difference in magnitude or duration between i.v. or i.n. doses. The effect is prolonged as long as the doses are repeated. Serum sodium is only marginally affected by single doses, but tends to decrease after four repeated doses with 12‐hr intervals. If desmopressin is repeated for a period of up to 48 hr, fluid intake should be restricted to 2 liters per day in adults. Am. J. Hematol. 57:153–159, 1998. © 1998 Wiley‐Liss, Inc.

Haemostatic treatment in connection with surgery in patients with von Willebrand disease

“…Since desmopressin has antidiuretic properties there must be an awareness of the risk of hyponatraemia. The antidiuretic effect of one haemostatic dose of desmopressin lasts for 24 h. The effect is prolonged as long as doses are repeated [10]. When doses are repeated, fluid intake should be restricted to 1500–2000 mL per day in adults, and the serum concentration of natrium should be monitored [10].…”

“…The antidiuretic effect of one haemostatic dose of desmopressin lasts for 24 h. The effect is prolonged as long as doses are repeated [10]. When doses are repeated, fluid intake should be restricted to 1500–2000 mL per day in adults, and the serum concentration of natrium should be monitored [10]. In children under the age of 2 years given desmopressin in connection with surgery, fluids should be restricted to three‐fourths maintenance or less, electrolytes and serum osmolality should be monitored in the first 24 h. Repeat doses of desmopressin should be avoided in small children if possible [11], and in those over the age of 65 years.…”

Pharmacologic Alternatives to Transfusion

“…Although DDAVP tends to be well tolerated, there are some adverse effects such as headache or flushing which are usually mild and short‐lived. Because DDAVP has antidiuretic activity, fluid retention can be a problem (9). DDAVP has been associated with thromboembolic effects and myocardial infarction in elderly patients suggesting that the drug be avoided in patients with known cardiovascular disease (10).…”

Desmopressin in the treatment of women’s bleeding disorders

“…In adults, one dose will not significantly effect serum natrium levels. Four repeated doses with 12 h intervals will give a small but significant decrease of serum natrium [ 38]. The effect is more pronounced in children who are more at risk of fluid overload.…”