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DESMOPRESSIN TABLETS

This medicine is supplied under the trade name DDAVPâ and is available as:

Tablets containing Desmopressin 0.1 mg (100 microgram) and 0.2 mg (200 microgram)

It is also supplied under the trade name DesmotabsÒ and available as:

Tablets containing 0.2 mg (200 microgram).

Desmopressin is chemically related to a natural hormone, vasopressin, which is produced in the body by the pituitary gland It is used to supplement vasopressin which is produced in insufficient quantities by patients with diabetes insipidus. Desmopressin mimics the action of vasopressin on the kidneys which results in concentration of the urine and hence normal urine volume and flow. Desmopressin is relatively specific in its action on the kidney so that it has little or no vasopressin-like activity elsewhere in the body. This medicine can also be delivered into the nostril (and therefore close to the pituitary gland) from where it is well absorbed into the circulation. When taken in tablet form, a relatively large amount of Desmopressin is destroyed in the stomach and before it is absorbed into the circulation. For this reason, you will note that there is a substantial difference in dosage between Desmopressin tablets and the intranasal forms (see separate leaflet).

The dose of Desmopressin must be carefully tailored to your needs. The daily dose for most people is in the range 0.2 mg (200 microgram) and 1.2 mg (1,200 microgram) or from one to six tablets of 0.2 mg (200 microgram) strength. This dose may then be adjusted according to your response to treatment.

Desmopressin by mouth acts for around 8 hours. It is usual therefore to take tablets three times daily. Tablets may be taken with or without food.

This treatment is usually well tolerated but headaches, stomach upsets and nausea have occasionally been reported. Such problems may be less likely to occur if tablets are taken with meals.

You should seek advice on the quantity of drinks you can take during treatment with Desmopressin - if indeed such advice is not already available. Since the action of this medicine is to retain water there is a possibility of inappropriate fluid retention if you drink an excessive amount. This applies to both alcoholic and non-alcoholic drinks.

The action of Desmopressin may be increased by some prescription medicines so that there is the possibility of inappropriate water retention when these are co-prescribed. Such medicines include the Antidepressants, Chlorpromazine, Carbamazepine (TegretolÒ ) and Indomethacin (IndocidÒ ). If this occurs it is easily overcome by suitable dosage adjustment. If in doubt, check with your doctor or pharmacist.

Storing your medicine

Desmopressin tablets should be stored at room temperature but avoid placing close to a heat source such as a fire or radiator. Tablets should be kept in the container in which they have been dispensed in order to protect them from light.

Note that if your medicine loses its potency during use you will easily recognise this because it will result in increasing need to empty your bladder.

This medicine is supplied under the trade name Desmosprayâ and is available as:

Intranasal Spray containing Desmopressin 10 microgram per dose (lower doses are occasionally used and for this purpose are produced in the Pharmacy by diluting the standard solution to the required concentration).

It is also supplied under the trade name DDAVPÒ and available as:

Intranasal Solution containing Desmopressin 100 microgram in 1 ml.

Desmopressin is chemically related to a natural hormone, vasopressin, which is produced in the body by the pituitary gland and is used to supplement vasopressin which is produced in insufficient quantities by patients with diabetes insipidus. It mimics the action of vasopressin on the kidneys which results in concentration of the urine and hence normal urine volume and flow. Desmopressin is relatively specific in its action on the kidney so that it has little or no vasopressin-like activity elsewhere in the body. This medicine can be delivered into the nostril (and therefore close to the pituitary gland) from where it is well absorbed into the circulation. Alternatively, it can be swallowed in tablet form (see separate leaflet) but when taken by this route, a relatively large amount of Desmopressin is destroyed in the stomach well before it is absorbed into the circulation. For this reason, there is a substantial difference in dosage between Desmopressin intranasal and Desmopressin tablet forms.

Intranasal Spray Desmosprayâ - delivers a metered dose (single spray) containing 10 microgram Desmopressin (unless the solution has been previously diluted in the Pharmacy). The usual dose is one or two sprays daily but ultimately this may be adjusted to provide normal urine volume and frequency of bladder emptying. A single spray only should be administered into one nostril at any given time. The method of use is described in the package insert. Briefly, it is as follows:

• First remove the protective cap.

• When first using the device it should be primed by pressing two or three times until a fine spray can be seen. It is also necessary to re-prime the device if it remains unused for one week or more.

• Tilt your head back slightly and place the nozzle just inside your nostril.

• Hold your breath (DO NOT SNIFF) then press the spray once.

• Repeat the procedure USING THE OTHER NOSTRIL if two doses are required at any one time.

• Replace the protective cap after use.

Intranasal Solution DDAVPÒ - delivers a range of doses which are determined by the volume of solution contained in the delivery tube or RhinyleÒ . A typical dose is as for Desmosprayâ , above. Ultimately, however, the dose which you require is that which provides a normal urine volume and frequency of bladder emptying. A single dose only should be administered into one nostril at any given time. The method of use is described in the package insert. Briefly, it is as follows:

• First break the container seal and remove the plastic cap.

• Twist off the small gnarled seal which sits atop the dropper.

• Remove one of the two plastic (RhinyleÒ ) delivery tubes provided with the pack and attach it to the device by inserting the unsealed dropper into the end marked ® .

• Squeeze the dropper neck to draw up the required volume of solution into the RhinyleÒ . The tube is marked in such a way to allow measurement of 0.05 ml, 0.1 ml, 0.15 ml and 0.2 ml which corresponds to doses of 5 microgram, 10 microgram, 15 microgram and 20 microgram, respectively.

• Remove the RhinyleÒ and insert the end marked ® into a nostril and place the free end in the mouth held firmly between the lips.

• Hold your breath, slightly tilt back your head then blow with a short but firm puff so that the solution is delivered into your nasal passage.

• After use, replace the plastic cap and rinse the RhinyleÒ tube in water before thoroughly shaking it dry.

This treatment is usually well tolerated. Headaches, stomach upsets and nausea have occasionally been reported.

Local irritation of the nasal passages may lead to nasal stuffiness, runny nose and possibly even minor bleeding from the nose.

You should seek advice on the quantity of drinks you can take during treatment with Desmopressin - if indeed such advice is not already available. Since the action of this medicine is to retain water there is a possibility of inappropriate fluid retention if you drink an excessive amount. This applies to both alcoholic and non-alcoholic drinks.

The action of Desmpressin may be increased by some prescription medicines so that there is the possibility of inappropriate water retention when these are co-prescribed. Such medicines include the Antidepressants, Chlorpromazine, Carbamazepine (TegretolÒ ) and Indomethacin (IndocidÒ ). If this occurs it is easily overcome by suitable dosage adjustment. If in doubt, check with your doctor or pharmacist.

Store DDAVPÒ in a refrigerator when not in use. On the other hand Desmosprayâ is stored at room temperature but avoid storing it close to a heat source such as a fire or radiator. Both products should be kept in their box to protect them from light.

An expiry date month/year is imprinted on the pack. Note that if your medicine loses its potency during use you will easily recognise this because it will result in increasing need to empty your bladder.

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Ó NHS Tayside; 2006; version 1.0

Disclaimer; no liability whatsoever is accepted for information given and all such information, especially with regard to drug usage (UK version provided), must be checked with a person’s health provider.