Desmopressin (DDAVP) in the treatment of bleeding disorders: the first twenty years

The use of desmopressin as a hemostatic agent: A concise review

“…The side effects of desmopressin have been well characterized and, in the vast majority of cases, they are transient and mild [1]. Mild tachycardia, headache, and facial flushing are not infrequent.…”

“…Desmopressin (1-deamino-8-D-arginine vasopressin, DDAVP) is a synthetic analogue of the antidiuretic hormone vasopressin originally designed for the treatment of diabetes insipidus [1]. DDAVP increases factor VIII (FVIII) and von Willebrand factor (VWF) plasma concentrations without important side effects when administered to healthy volunteers or patients with mild hemophilia and von Willebrand disease (VWD) [2,3].…”

“…Following these early observations, DDAVP has become widely used for the treatment of these diseases [5]. However, the clinical indications for desmopressin quickly expanded beyond hemophilia and VWD and this drug was shown to be efficacious in many hemorrhagic situations not involving a deficiency or dysfunction of FVIII or VWF or as a blood saving agent [1].…”

Bleeding in a Jehovah’s Witness patient undergoing a redo aortic valve replacement controlled with cryoprecipitate and a prothrombin complex concentrate

“…The use of DDAVP is less well established in cardiac surgery, but when blood loss is [ 1 L, the compound has been shown to have significant effect. 12 During cardiopulmonary bypass, blood interacts with tubings and membranes of the oxygenator resulting in activation of the complement system, the coagulation system, and the fibrinolytic system. This results in activation of inflammatory response cells and platelets.…”

Effectiveness in controlling haemorrhage after dental scaling in people with haemophilia by using tranexamic acid mouthwash

“…It has been estimated that for medication alone, the cost per bleeding episode for a child of 20 kg varies from £54 to £493 and that for an adult varies from £90 to £822.50 depending on the severity of the bleeding, and the purity, type and amount of F VIII used. 6 Release of endogenous F VIII stores from endothelial cells to the blood stream 7 can be stimulated by the use of the hormone desmopressin (DDAVP). DDAVP can be used to increase plasma concentrations of F VIII in people with mild to moderate haemophilia A for a short time.…”