Indications & Dose:
- Type I von Willebrand disease
- 1-3 μg/kg SC (can use the injectable solution or the nasal spray) for clinical bleeding – peak effect in 10 minutes, lasts around 2 hours, repeated doses less effective for 48 hours or so
- Central diabetes insipidus
- 1-4 drops of the intranasal spray into the nostril, conjunctival sac, vulva or prepuce q12-24h
- 0.1mg tablet PO q8-12h, increase to effect
Formulations:
- Intranasal DDAVP 0.01% (100 µg/mL), roughly 5 µg/drop
- Injectable desmopressin acetate (4 µg/mL)
- Desmopressin 0.1 and 0.2 mg tablets
Adverse Effects:
- Nausea
- Abdominal pain
- Hyponatremia
Mechanism of action:
- Synthetic analog of vasopressin and antidiuretic hormone – binds to V2 receptors in the renal collecting ducts leading to water reabsorption via aquaporin channels
- Stimulates release of vWF from endothelial cell Weibel-Pallade bodies