Desmopressin

What is desmopressin?

Desmopressin is a hormone (chemical) produced by the body. It acts on the kidneys to reduce the flow of urine. It is used in certain disorders to control increased thirst, frequent urination, and urination with large amounts of dilute urine (diabetes insipidus). It is also used to control bedwetting (enuresis).

Desmopressin also increases the body's ability to make blood-clotting products. For this reason, desmopressin is given by injection (needle) to treat patients with bleeding problems such as certain types of hemophilia and von Willebrand's disease.

You may also hear desmopressin called by its brand names, DDAVP, Minirin, or Octostim. It comes as a tablet, nasal spray, nasal solution, and injection.

Before giving desmopressin to your child

• Be sure to tell your doctor if your child has ever reacted badly to desmopressin in the past.

Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• a history of blood clots
• cystic fibrosis
• a history of heart problems or high blood pressure

How should you give your child desmopressin?

Follow these instructions if your child is taking desmopressin tablets:

• For bed-wetting, give 1 hour before bedtime or as directed by your child's doctor.
• If your child cannot swallow the tablets, tablets can be chewed or crushed and mixed with soft food such as applesauce.

If your child is taking desmopressin nasal spray, note that the spray should NOT be sniffed like some other nasal products such as cold or allergy medicines.

Follow these instructions when giving your child desmopressin nasal spray:

• Do not shake the bottle.
• Always keep the bottle upright. Do not store the spray bottle on its side.
• Before using a bottle for the very first time, make sure to prime the sprayer by pressing down on the white ring several times to bring the liquid up into the sprayer.
• Have your child blow their nose gently to clear the nostrils.
• Tilt the child's head back a little bit.
• Insert the sprayer into their nostril.
• Have your child take a deep breath then hold their breath as you squeeze the sprayer once.
• Remove the sprayer from the nostril. To stop mucus from going into the sprayer, release your grip after you remove the sprayer.
• Have your child place one finger on the outside of the nostril. Slowly count to 10 out loud. This prevents the solution from dripping out. If your child sniffs the spray or says the spray tastes bad, then the medicine was not given properly and will not work as well.
• If more than one spray is needed, repeat the steps using the other nostril for the next spray.

Follow these instructions if your child is taking desmopressin by nasal solution (such as DDAVP Rhinyle nasal solution):

• There are instructions with pictures in the desmopressin package. Ask your pharmacist (or nurse) to explain these instructions to you.
• Use the soft, flexible tube in the package to measure the dose of desmopressin. This tube has markings on it for the dose. Ask your pharmacist to show you how much to measure.
• After you measure the dose, hold the end of the tube and place one end in your child's mouth. Then place the other end in your child's nostril.
• Have your child tilt their head back.
• Have your child blow a short, strong puff into the tube. This makes the liquid move from the tube into the nose.

A nurse may give desmopressin to your child into a vein (intravenously, IV) or under the skin (subcutaneously, "sub-Q"). If you give your child the injections subcutaneously at home:

• Ask your nurse, pharmacist or doctor to teach you how to give the medicine.
• To open the glass container (ampoule) that contains the medicine, hold it with the blue dot pointing upwards. Gently tap the container to empty the medicine from the tip. Then, with the blue dot pointing upwards, snap off the tip by forcing it downward. You may wish to cover the neck of the glass container with cloth to protect against any accidental cuts.
• Use a needle and syringe to measure the dose of desmopressin. Ask your nurse or pharmacist to show you how much to measure.
• Inject the dose under your child's skin exactly as your child's nurse has taught you.
• Put the used needle and ampoule in a special waste container called a sharps. Ask your nurse, doctor, or pharmacist where you should get a sharps container for use at home.

What should you do if your child misses a dose of desmopressin?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does desmopressin take to work?

• After the tablet or nasal spray/solution is given, desmopressin usually starts to work within 1 hour.
• After an injection is given, desmopressin usually starts to work within 15 to 30 minutes.

What are the possible side effects of desmopressin?

Your child may have some of these side effects while they take desmopressin. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:

• stomach cramps, upset stomach
• flushing or redness of the skin
• pain in the vulva (genital area outside the vagina in girls)
• for the nose spray or solution: cough, sneezing, nosebleed, stuffy or runny nose, sore throat
• for the injection: pain, redness, or swelling at the injection site

Call your child's doctor during office hours if your child has any of these side effects:

• fast heart beat
• rapid weight gain

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to the Emergency Department if your child has any of these side effects:

• unexplained chills or fever
• confusion, seizures, unusual drowsiness
• headache that does not go away
• not going to the bathroom or urinating very little
• shortness of breath, tightness in chest, trouble breathing, or wheezing
• chest pain
• raised, red, itchy areas on the skin (hives)

What safety measures should you take when your child is using desmopressin?

Your child's doctor may tell you to limit your child's intake of fluids for a short period of time (such as 12 hours) following the dose of desmopressin. Drinking too much fluid may cause your child to have headaches, vomiting (throwing up), bloating, or swelling of the feet, ankles, and lower legs. In rare circumstances (particularly in very young children), it may even lead to a seizure.

If you child is vomiting (throwing up) or has diarrhea (loose, watery bowel movements) while they are taking desmopressin, contact your child's doctor immediately. The dose of desmopressin may have to be adjusted.

Let your doctor or pharmacist know if your child takes lithium, large doses of epinephrine (adrenaline), demeclocycline (Declomycin), heparin, fludrocortisone (Florinef), or carbamazepine (Tegretol) as the dose of desmopressin may need to be adjusted.

Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).

What other important information should you know about desmopressin?

• Keep all appointments at the clinic or doctor's office for blood tests so that your child's response to desmopressin can be checked.
• Before your child has any kind of surgery, including dental surgery or emergency treatment, tell the doctor or dentist that your child is taking desmopressin.
• Keep a list of all medications your child is on to show the doctor or pharmacist.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Make sure you always have enough desmopressin to last through weekends, holidays, and vacations. Call your pharmacy at least 2 days before your child runs out of medicine to order refills.
• Keep desmopressin tablets and nasal spray at room temperature in a cool, dry place away from sunlight.
• Keep desmopressin nasal solution (Rhinyle solution) and injection in the refrigerator. Do not freeze this medicine.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep desmopressin out of your child’s sight and reach and locked up in a safe place. If your child takes too much desmopressin, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.