Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 1 After the original clinical study performed in Italy, desmopressin was used in Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. sharing sensitive information, make sure youre on a federal Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. A woman who took both desmopressin and ibuprofen was found in a comatose state. DDAVP/Desmopressin Injection - Summary of Product Characteristics (SmPC Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The necessity for repeat administration of desmopressin acetate or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Telmisartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Initially, 0.2 mg PO once daily at bedtime. Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Hemophilia A and von Willebrand's Disease (Type I): The recommended dosage is 0.3 mcg/kg actual body weight (to a maximum of 20 mcg) administered by intravenous infusion over 15 minutes to 30 minutes. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. Following oral administration, the half-life of desmopressin is about 1.5 to 2.5 hours and is independent of dosage. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Indomethacin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. May repeat dose if needed. 2 mg PO - 15 mg IV. Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. Monitor patients for signs or symptoms of hypersensitivity reactions during administration, interrupt treatment should a reaction occur, and manage medically. DDAVP: Dosing, contraindications, side effects, and pill - Epocrates Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. It may be given in the nose, by injection into a vein, by mouth, or under the tongue. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Usual Adult Dose for Diabetes Insipidus Initial dose: 0.05 mg orally twice a day or 1 to 2 mcg IV twice a day or 1 to 2 mcg subcutaneously twice a day or 5 to 40 mcg spray intranasally twice a day or 0.1 to 0.4 mL via rhinal tube intranasally twice a day. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fenoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin nasal sprays may not be substituted for each other due to significant differences in concentration. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Desmopressin is contraindicated in persons with moderate to severe renal impairment (CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2) and renal failure. Inject subcutaneously taking care not to inject intradermally. Initially, 10 mcg (0.1 mL) intranasally into 1 nostril, may increase to 40 mcg until the patient can sleep for an adequate period of time without incidence of polyuria. FOIA Loop diuretics: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Ketorolac (Toradol) Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. Ensure that serum sodium is normal prior to initiating or resuming treatment with DDAVP Injection. 0.1 to 0.4 mL via rhinal tube intranasally twice a day. PDF Intravenous to Oral Therapy Conversion - FormWeb The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Bisoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. Dose range is 0.1 to 0.8 mg daily. 1 0 obj Fosinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Treatment longer than 4 to 8 weeks has not been studied. If the patient was previously receiving desmopressin tablets, dose titration is required because intranasal desmopressin is approximately 10 to 40 fold more potent than oral (tablet) desmopressin. 1999 Dec;84 Suppl 1:5-8 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. IV: 0.3 mcg/kg by slow infusion over 15 to 30 minutes beginning 30 minutes before procedure. 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. The pharmacokinetic profile of desmopressin is biexponential. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. Prednisone: (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. Decompensated Hypothyroidism ("Myxedema Coma") - EMCrit Project A woman who took both desmopressin and ibuprofen was found in a comatose state. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Carbamazepine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including carbamazepine. Increased Factor VIII activity is noted 30 minutes after IV administration, with peak activity occurring in 90 minutes to 2 hours. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). IV: 0.3 mcg/kg by slow infusion over 15-30 minutes beginning 30 minutes before procedure. The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. May repeat dose after 8 to 12 hours and once daily thereafter as needed to reduce spontaneous or traumatic bleeding. 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. Guardrail Drug Requires documentation of two (2) RN's for double-checking. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diflunisal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. For the treatment of hypothyroidism of any etiology, except during the recovery phase of subacute thyroiditis; used as a replacement in primary (thyroidal), secondary (pituitary), tertiary (hypothalamic), congenital (cretinism), or acquired hypothyroidism. 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. Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Repeat administration should be determined by laboratory response and clinical condition of the patient. Levels of FVIII are also increased, which increases hemostasis by accelerating fibrin formation. 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 . In general, desmopressin is contraindicated in persons with heart failure or uncontrolled hypertension because fluid retention increases the risk for worsening of underlying conditions that are susceptible to volume status. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. 1996 Sep;42(3):379-85 Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. -The most preferred drug is desmopressin acetate (DDAVP), a synthetic form of vasopressin given orally, as a sublingual "melt," or intranasally in a metered spray. Hougaard C, Matthiesen TB, Rittig S, Djurhuus JC. The mechanism of action of desmopressin in <> Disclaimer. Persons with vWD subtype 1C, which is characterized by a shorted vWF half-life, may require alternative management in the setting of surgery. Desmopressin has also been used in congenital or acquired bleeding disorders, including drug-induced platelet dysfunction (e.g., aspirin, dextran, ticlopidine, and heparin). A woman who took both desmopressin and ibuprofen was found in a comatose state. Child 2-11 years The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Esomeprazole: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or enteral nutrition and/or receiving oral medications Infection does not require IV antibiotics Afebrile (< 100.4F in the last 24 hours) Received 24 hours of IV antibiotics Ferring Statement on Minirin / Octostim / DDAVP / Stimate IV: 0.3 mcg/kg once slowly over 15-30 minutes. Taking control of severe hyponatremia with DDAVP - EMCrit Project Desmopressin increases plasma factor VIII (FVIII) and von Willebrand factor (vWF) to a greater extent than equivalent weights of vasopressin. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 2023 Feb 10;21:eRC0124. DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. dose conversion. Interrupt therapy for acute illness (e.g., systemic infection, fever, recurrent vomiting or diarrhea), extremely hot weather, vigorous exercise, or other conditions associated with increased water intake. Methylprednisolone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Unlike nearly all other benzodiazepine conversions, the conversion between intravenous midazolam and lorazepam has been well studied in mechanically ventilated patients. Hydrocodone; Ibuprofen: (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. Confirm responsiveness before using desmopressin for therapeutic interventions. 1. 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. Main menu. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Oxycodone: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. 1998 Nov;82(5):642-6 Acetaminophen; Guaifenesin; 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. Adults and children 12 years of age and older0.5 to 1 milliliter (mL), divided into 2 doses and injected under the skin in the morning and evening. stream Factors associated with mortality of myxedema coma: report of eight cases and literature survey. 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. Tolmetin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. There is no increase in activity with doses greater than 0.4 mcg/kg, despite increases in desmopressin concentrations. Desmopressin acetate | CHEO ED Outreach The recommended maintenance dose is 5 mcg/day to 30 mcg/day (0.05 mL/day to 0.3 mL/day) intranasally in single or divided doses. In infants, doses less than 5 mcg (0.05 mL) may be necessary. Repeat dosing is not recommended due to tachyphylaxis. conversion from INTRAVENOUS TO ORAL DOSING----- design of - SlideShare If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. ea1`-@te3;plr*5L%5Ko=UNed Pediatric Pharmacology of Desmopressin in Children with Enuresis: A Comprehensive Review. Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. endobj On Days 1, 3 and 5, subjects were dosed intranasally with escalating doses of AV002 nasal spray. PLEASE READ THE. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. Treatment has been given safely to pediatric patients for up to 6 months. 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. Renal concentration capacity testing in children below the age of 1 year should only be performed under carefully supervised conditions in hospital. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. The concentration-time curve after 2 microg intravenous desmopressin was best described using a biexponential term. 2005 Apr;95(6):804-9. doi: 10.1111/j.1464-410X.2005.05405.x. Triamcinolone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The hemostatic effects of desmopressin are mediated through V2 receptor agonist activity, as patients with nephrogenic diabetes insipidus, who lack this receptor, do not have a hemostatic response to desmopressin. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 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. Please enable it to take advantage of the complete set of features! If used preoperatively, administer 2 hours before surgery. What is the difference in Nocdurna dosage between men and women. Etodolac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Prepare the solution for infusion using aseptic technique. Adjust treatment according to the diurnal pattern of response. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 6 years or older: x}n y)Zn91Iv l38Y8bIkYbX$=x:9\>?}st_~xOo^\~dt&&=\~o~g/}~y%;]V|s{h+j/~\f'iqriwZgI~IOk[b,n6'K+%Y{Y?k{]U4{H}mWRa |3}ktz_>iCy>VbZ{SZ(_!> _~{pz.5'Kxo'wW0P*okGa? Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. The site is secure. Azelastine; Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. DDAVP, Minirin, Nocdurna, Stimate, +2 more. Do not dilute DDAVP Injection for the Diabetes Insipidus population. A woman who took both desmopressin and ibuprofen was found in a comatose state. Amlodipine; Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. When administered to patients with central diabetes insipidus, desmopressin exerts antidiuretic effects similar to those of vasopressin; a reduction in urine output with an accompanying increase in urine osmolality and a decrease in clinical symptoms of urinary frequency and nocturia are noted following desmopressin treatment. Fluid restrictions should be observed. DDAVP (Desmopressin Acetate Tablets) may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. Serum concentrations of potassium, sodium, and creatinine do not change following the administration of desmopressin, and urinary excretion of potassium and sodium also remains the same. [61810], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. Blood pressure and pulse should be monitored during infusion. IV: 0.3 mcg/kg once slowly over 15 to 30 minutes. How can you convert an orally administered dose to intraperitoneal The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. eCollection 2023. Antidiuretic effects usually occur within 15 to 60 minutes, with peak effects evident 1 to 5 hours after nasal administration. 3 0 obj For antimicrobial interchanges: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per protocol. 55.3 mcg sublingually once daily, 1 hour before bedtime without water. 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. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication.[42295].
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