desmopressin iv to po conversion

Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Carbetapentane; Diphenhydramine; 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. Permanently discontinue for serious hypersensitivity reaction. DOSAGE AND ADMINISTRATION Hemophilia A and von Willebrand's Disease (Type I): Desmopressin Acetate Injection 4 mcg/mL is administered as an intravenous infusion at a dose of 0.3 mcg desmopressin acetate/kg body weight diluted in sterile physiological saline and infused slowly over 15 to 30 minutes. Twist off the seal from the dropper. Lithium: (Moderate) The antidiuretic response to desmopressin may be reduced in patients receiving lithium concomitantly. The mechanism of action of desmopressin in Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Main menu. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil. Median time to reach Cmax (tmax) was 1.5 (range 1.0-4.1) h at night and 1.5 (range 0.5-3.0) h in the day. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Cyclizine SC or IV Nausea and vomiting 0.5 1 14.5 0 Diamorphine$ SC or IV Pain 0.075 0.1 2.175 2.9 1.45 3.2625 Diazepam PR Agitation, convulsions 10 Hydrocortisone IV Anaphylaxis 2 4 58 116 Hyoscine hydrobromide SC or IV Respiratory tract secretions 0.01 0.01 0.29 0.29 Midazolam SC or IV Anxiety or agitation 0.06 0.1 1.74 2.9 2 4.5 Preoperative doses may be given 2 hours prior to the scheduled procedure. [42295], 2 to 4 mcg IV or subcutaneously given in 1 or 2 divided doses daily. Prolonged experience with desmopressin in pregnant women over several decades, based on the available published literature and case reports, have not identified a drug associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. 2002 Jun;89(9):855-62 The site is secure. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. On Days 1, 3 and 5, subjects were dosed intranasally with escalating doses of AV002 nasal spray. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. endobj Dose: 0.1-1.2 mg/day PO divided bid-tid; Start: 0.05 mg PO bid; Max: 1.2 mg/day; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; restrict fluid intake [parenteral route] Dose: 2-4 mcg/day SC/IV divided qd-bid; Info: parenteral dose is approx. Intranasal: 5 to 40 mcg/day divided into 1 to 3 doses. Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Initially, 0.05 mg PO twice daily, then titrate to response. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Desmopressin is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min). <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma. A woman who took both desmopressin and ibuprofen was found in a comatose state. Preoperative doses may be given 2 hours prior to the scheduled procedure. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. <>/Metadata 2732 0 R/ViewerPreferences 2733 0 R>> Eprosartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 3 0 obj endobj Blood pressure and pulse should be monitored during infusion. Children more than 12 years of age: Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 4 0 obj 3 0 obj Desmopressin should be avoided in women with preeclampsia and those with cardiovascular disease due to the fact that oxytocin and IV fluids are often used during labor and delivery, both of which increase the risk of desmopressin-induced hyponatremia. Adjust dose based upon response to treatment estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Preserve in tight containers, protected from light. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Maximal dose-response increase in Factor VIII activity occurs at 0.3 to 0.4 mcg/kg desmopressin. Unauthorized use of these marks is strictly prohibited. Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. Administer with a 0.22 micron filter. Vincristine Liposomal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task. 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. Carbetapentane; 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. Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. > = 12 years and adult: 2-4 mcg/day IV/SC divided BID or 1/10 of the . 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. Infants 3 months of age and children: If administered more than once a day, adjust for an adequate diurnal rhythm of urine output. September, 2004 Hospira 2004 EN-0511 Printed in USA HOSPIRA, INC., LAKE FOREST, IL 60045 USA. Pharmacokinetic parameters were derived using a two-compartmental model except for AUC(0-->t), which was derived using non-compartmental analysis. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The https:// ensures that you are connecting to the Desmopressin is found in breast milk, but not in significant amounts. 1 0 obj Sublingual TabletsThe patient should place the tablet under their tongue 1 hour before bedtime until it dissolves.Have the patient empty their bladder just before bedtime.Advise patients to limit the amount of water or liquids they drink from 1 hour before taking desmopressin sublingual tablet and until 8 hours after. Careful fluid intake restrictions are required to prevent hyponatremia and water intoxication. Piroxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 2 0 obj 2 mg PO - 15 mg IV. In the elderly, careful dosage selection and monitoring of renal function are recommended. 0.3 mcg/kg IV over 15-30 minutes; for pre-op, give 30 minutes before procedure. Example: Ampicillin-sulbactam 1.5gm IV Q6H to amoxicillin-clavulanic acid 875mg/125mg PO Q12H. Carbamazepine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including carbamazepine. Trauma Surg Acute Care Open. The initial response is reproducible if desmopressin is given every 2 to 3 days. Dextromethorphan; 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. Keep this seal as it is reversed to prevent leakage from the dropper.Squeeze the correct dose into this tube from the dropper bottle. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. 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. PMC Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. Prepare the solution for infusion using aseptic technique. Carbetapentane; Chlorpheniramine; 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. hydromorphone dose conversion. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Desmopressin (dDAVP), a synthetic analogue of 8-arginine vasopressin (ADH), is an antidiuretic . Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. Ketorolac (Toradol) A woman who took both desmopressin and ibuprofen was found in a comatose state. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. Increased Factor VIII activity is noted 30 minutes after IV administration, with peak activity occurring in 90 minutes to 2 hours. It is not known if the drug is metabolized; however, in contrast to vasopressin, desmopressin does not appear to be degraded by the peptidase enzymes responsible for metabolizing endogenous vasopressin during the last trimester of pregnancy. For endotoxin-induced fever, IV is favored over PO acetaminophen in reducing temperature for up to . Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Budesonide; Glycopyrrolate; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Preoperative doses may be given 2 hours prior to the scheduled procedure. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. Olopatadine; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. A woman who took both desmopressin and ibuprofen was found in a comatose state. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. News Article Holder This page will generate the the news article from the ID supplied in the URL. Oxaprozin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. administer single spray (150 mcg) if patient >12 years of age but <50 kg body weight. Desmopressin: Corticosteroids (Systemic) may enhance the hyponatremic . A woman who took both desmopressin and ibuprofen was found in a comatose state. Initially, 0.05 mg PO twice daily. Longer DOA. 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. Desmopressin acetate should not be used to treat patients with Type IIB von Willebrands disease since platelet aggregation may be induced. Persons with vWD type 1 and von Willebrand factor (vWF) concentrations less than 0.3 International Units/mL or factor VIII activity equal to or less than 5% of normal may not respond to desmopressin. %PDF-1.5 Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Do Not Copy, Distribute or otherwise Disseminate without express permission. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Response should be estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin acetate 200 microgram tablets; 10microgram/mL WCHN prepared solution; 4microgram/mL injection solution - SA Neonatal Medication Guidelines | SA Health Medication guideline for the management of neonates requiring desmopressin acetate. Desmopressin is contraindicated in patients with moderate to severe renal impairment (e.g., CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2). Put the other end of the tube into the patients mouth; the patient should hold their breath.Tilt the patient's head back and have them blow with a short strong puff through the tube. Aliskiren; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Unable to load your collection due to an error, Unable to load your delegates due to an error. During treatment with DDAVP Injection, assess serum sodium, bleeding time, factor VIII coagulant activity, ristocetin cofactor activity, and von Willebrand antigen to ensure that adequate levels are being achieved. Preoperative doses may be given 2 hours prior to the scheduled procedure. Infants 3 months of age to children 12 years of age: 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 . Repeat administration should be determined by laboratory response and clinical condition of the patient. Brompheniramine; Dextromethorphan; 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. Enalapril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Dose should be reduced. THOSE AT INCREASED RISK FOR HYPONATREMIA: 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Tolmetin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin is not effective in persons with type 3 von Willebrand's disease (vWD) and can cause platelet aggregation, thrombocytopenia, and possibly thrombosis in persons with type 2B vWD. This places the solution in the nasal cavity and not down your throat.After use, reseal the dropper tip and close the bottle. dose conversion. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. Atenolol; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Monitor blood pressure and pulse during infusion. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. Consider other treatment options for this condition. 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. Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral desmopressin). Desmopressin intranasal formulations are no longer indicated for the treatment of primary nocturnal enuresis due to the risk for developing severe hyponatremia that can result in seizures and death. However, desmopressin is used off-label as a single injection for uremic bleeding in persons with renal failure. 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. <> Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. Your doctor may adjust the dose as needed. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Mefenamic Acid: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 2 0 obj Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Methods: The study had an open, randomised, four-way cross-over design. Bioavailability and pharmacokinetics of desmopressin in elderly men. Monitor patients for signs or symptoms of hypersensitivity reactions during administration, interrupt treatment should a reaction occur, and manage medically. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Barnabei A, Strigari L, Corsello A, Paragliola RM, Iannantuono GM, Salvatori R, Corsello SM, Torino F. Front Endocrinol (Lausanne). If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Dependent on route of administration and indication for therapy. If there are dry nights after Desmopressin is used, continue using it for 3 months and then review your child's progress. Baseline renal function should be assessed. Find medical information for DDAVP on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. Commonly central DI is treated with desmopressin. 0.02 mg IN, 0.2 mg PO and 0.4 mg PO) have a similar, pronounced pharmacodynamic effect on urine volume and urine osmolality. Medically reviewed by Drugs.com. Initially, 0.05 mg PO once daily. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Greatly enhanced ADH activity.