NAME OF DRUG
desmopressin

CLASSIFICATION

Antidiuretic Hormone

ALTERNATE NAME

DDAVP

 INDICATIONS

• antidiuretic hormone replacement therapy in primary and secondary central diabetes insipidus
• to control bleeding from trauma or during minor surgical procedures in patients with hemophilia A or Type I von Willebrand's disease
• reduction of excessive surgical blood loss (e.g. cardiopulmonary bypass surgery)

 RECONSTITUTION AND STABILITY

• refrigerate; protect from freezing
• diluted solution in NS stable x 24 hours at room temperature

 COMPATIBILITY

• compatible with NS
• incompatible with other drugs and solutions

 ROUTES OF ADMINISTRATION

• SC
• IM
• IV intermittent - dilute in 50 mL NS and administer over 30 minutes
• for children weighing less than 10 kg, use 10 mL of NS

 VH & HSC ADMINISTRATION POLICY

A - Not to be administered by the direct IV route.

 DOSAGE

Diabetes insipidus:

Adults: 1-4 mcg daily SC, IM, IV; in one or two doses

Children: 0.4 mcg once daily SC, IM, IV

Hemophilia A and Type I von Willebrand's disease:

Adults and children:  0.3 mcg/kg (or 10 mcg/m²) IV over 30 minutes

Reduction of surgical blood loss:

Adults and children: 0.3 mcg/kg (or 10 mcg/M²) IV over 30 minutes

 POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

• local erythema, swelling, and burning pain at injection site; severe pain along the injected vein with large doses
• headache, nausea, mild abdominal pain, vulval pain, facial flush, slight increase in blood pressure:  these symptoms respond to decreasing the dose
• tachycardia, hypotension with large doses

 IMPORTANT IMPLICATIONS

• desmopressin can cause platelet aggregation and thrombocytopenia in Type II B von Willebrand's disease and should not be used for that disorder
• avoid excessive fluid intake to prevent the antidiuretic effect of the drug from causing hyponatremia and water intoxication, especially in children and the elderly
• desmopressin has no effect on severe Factor VIII deficiency

Rev. Sept 2000