Desmopressin Pharmacology

Desmopressin

About Desmopressin
Synthetic analogue of natural pituitary hormone 8-arginine vasopressin (ADH), antidiuretic hormone,in diabetes insipidus, Hemostatic Agent, Antihemophilic Agent.
Mechanism of Action of Desmopressin
The drug exerts it`s antidiuretic action by acting as a selective V2 receptor agonist. The activation of V2 receptor present on basolateral side of cell membrane of collecting duct increases intracellular cyclic AMP formation; which leads to activation of cyclic AMP dependent protein kinase A and phosphorylation of relevant proteins. This phosphorylation promotes exocytosis of "aquaporin-2" water channels containing vesicles (WCVs) through apical membrane and more aqueous channels get inserted in to the apical membrane. Endocytosis and degradation of WCVs is also decreased. The water permeability of collecting duct cells increases in proportion to the population of aquaporin-2 channels in the apical membrane. Continuous V2 receptor stimulation also up regulates aquaporin-2 synthesis through cyclic AMP response element of gene encoding aquaporin-2. V2 receptor activation also increases urea permeability of terminal part of collecting duct by stimulating a vasopressin regulated urea transporter which increases medullary hyper tonicity.
Pharmacokinets of Desmopressin
Absorption: About 10 to 20% of dose is absorbed after intranasal administration and bioavailability after oral administration is 1 to 2%.
Onset of Action for Desmopressin
N/A
Duration of Action for Desmopressin
8 to 12 hours
Half Life of Desmopressin
1 to 2hours
Side Effects of Desmopressin
1.Headache
2.Hyponatraemia
3.Fluid retention
4 Stomach pain
5.Nausea
6.Vomiting
7.Abdominal cramps
8.Epistaxis
9.Sore throat
10.Allergic manifestations
11.Urticaria
12.Anaphylaxis.
Contra-indications of Desmopressin
1.Hypersensitivity to the drug
2.Type IIB Von Willebrand`s disease
3.Cardiac insufficiency
4.Conditions treated with diuretics
Special Precautions while taking Desmopressin
1 Renal impairment
2.Hypertension
3 Cardiovascular disease
4.Cystic fibrosis
5.Fluid and electrolyte imbalance.


Pregnancy Related Information
Contraindicated.
Old Age Related Information
Contraindicated.
Breast Feeding Related Information
Contraindicated.
Children Related Information
Use with caution
Neonates: Contraindicated
Indications for Desmopressin
1.Diabetes insipidus treatment and diagnosis
2.Primary nocturnal enuresis
3.Nocturia associated with multiple sclerosis
4 Kidney function test.
Interactions for Desmopressin
Analgesics: Effect of desmopressin potentiated by indomethacin.

Typical Dosage for Desmopressin
Diagnosis of diabetes insipidus: 20mcg
Adult:
Intranasal:
Diagnosis of diabetes insipidus: 20mcg
Diabetes insipidus treatment: 10 to 40mcg in 1 to 3 divided doses. Use the lowest effective dose and separately adjust morning and evening doses for adequate diurnal rhythm of water turn over.
Primary nocturnal enuresis: 20mcg as two to four metered sprays intranasally at bed time. Adjust the dosage based on patient`s response.Maximum dose: 40mcg/day.
Kidney function test:40mcg after bladder emptying
Oral:
Diabetes insipidus: 100 to 200mcg thrice daily.

Children: 5 to 20mcg at bed time.
Primary nocturnal enuresis: children above 6 years:20mcg as two to four metered sprays intranasally at bed time. Adjust the dosage based on patient`s response.Maximum dose: 40mcg/day.
Kidney function test: 20mcg after bladder emptying
Children below 1 year old: 10mcg
Reduce fluid intake to half for further two feeds
Nocturia associated with multiple sclerosis: 10 to 20mcg at bed time.

Schedule of Desmopressin
H
Storage Requirements for Desmopressin
Store in upright position at controlled room temperature at a range of 20 to 25 degree C. Keep out of reach of children
Effects of Missed Dosage of Desmopressin
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.

Effects of Overdose of Desmopressin
Treatment includes water restriction and temporary withdrawal of Desmopressin until polyuria occurs. Severe water intoxication requires osmotic diuresis with Mannitol, dextrose, or urea (alone or with Furosemide).

Home Delivery for Desmopressin in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including desmopressin.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for desmopressin and other medicines and health products. Home delivery services for desmopressin may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take desmopressin only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for desmopressin before they complete the sale. You can get this information while placing the order for desmopressin with the pharmacy.

Desmopressin is a generic medicine name and there are several brands available for it. Some of the brands for desmopressin might be better known than desmopressin itself. If the pharmacy that's willing to deliver medicines to your home doesn't have desmopressin in stock, you can ask for one of the branded alternatives for desmopressin.