▶BY SUBLINGUAL ADMINISTRATION
▶Child 2–17 years:Initially 60 micrograms 3 times a day,
adjusted according to response; usual dose
40 – 240 micrograms 3 times a day
▶BY INTRANASAL ADMINISTRATION
▶Neonate:Initially 100 – 500 nanograms, adjusted
according to response; usual dose 1. 25 – 10 micrograms
daily in 1 – 2 divided doses.
▶Child 1–23 months:Initially 2. 5 – 5 micrograms 1 – 2 times
a day, adjusted according to response
▶Child 2–11 years:Initially 5 – 20 micrograms 1 – 2 times a
day, adjusted according to response
▶Child 12–17 years:Initially 10 – 20 micrograms 1 – 2 times
a day, adjusted according to response
▶BY INTRAMUSCULAR INJECTION
▶Neonate:Initially 100 nanograms once daily, adjusted
according to response.
▶BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR
INJECTION
▶Child 1 month–11 years:Initially 400 nanograms once
daily, adjusted according to response
▶Child 12–17 years:Initially 1 – 4 micrograms once daily,
adjusted according to response
Primary nocturnal enuresis
▶BY MOUTH
▶Child 5–17 years: 200 micrograms once daily, only
increased to 400 micrograms if lower dose not
effective; withdraw for at least 1 week for reassessment
after 3 months, dose to be taken at bedtime, limitfluid
intake from 1 hour before to 8 hours after
administration
▶BY SUBLINGUAL ADMINISTRATION
▶Child 5–17 years: 120 micrograms once daily, increased
if necessary to 240 micrograms once daily, dose to be
taken at bedtime, limitfluid intake from 1 hour before
to 8 hours after administration, dose to be increased
only if lower dose not effective, reassess after 3 months
by withdrawing treatment for at least 1 week
Diabetes insipidus, diagnosis (water deprivation test)
▶BY INTRANASAL ADMINISTRATION
▶Neonate:Not recommended, use trial of treatment.
▶Child 1–23 months: 5 – 10 micrograms for 1 dose, manage
fluid input carefully to avoid hyponatraemia, not
usually recommended
▶Child 2–11 years: 10 – 20 micrograms for 1 dose, manage
fluid input carefully to avoid hyponatraemia
▶Child 12–17 years: 20 micrograms for 1 dose, manage
fluid input carefully to avoid hyponatraemia
▶BY INTRAMUSCULAR INJECTION, OR BY SUBCUTANEOUS
INJECTION
▶Neonate:Not recommended, use trial of treatment.
▶Child 1–23 months: 400 nanograms for 1 dose, manage
fluid input carefully to avoid hyponatraemia, not
usually recommended
▶Child 2–11 years: 0. 5 – 1 microgram for 1 dose, manage
fluid input carefully to avoid hyponatraemia
▶Child 12–17 years: 1 – 2 micrograms for 1 dose, manage
fluid input carefully to avoid hyponatraemia
Renal function testing
▶BY INTRANASAL ADMINISTRATION
▶Child 1–11 months: 10 micrograms, empty bladder at
time of administration and restrictfluid intake to 50 %
at next 2 feeds to avoidfluid overload
▶Child 1–14 years: 20 micrograms, empty bladder at time
of administration and restrictfluid intake to 500 mL
from 1 hour before until 8 hours after administration to
avoidfluid overload
▶Child 15–17 years: 40 micrograms, empty bladder at time
of administration and limitfluid intake to 500 mL from
1 hour before until 8 hours after administration to
avoidfluid overload
▶BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR
INJECTION
▶Child 1–11 months: 400 nanograms, empty bladder at
time of administration and restrictfluid intake to 50 %
at next 2 feeds to avoidfluid overload
▶Child 1–17 years: 2 micrograms, empty bladder at time of
administration and restrictfluid intake to 500 mL from
1 hour before until 8 hours after administration to
avoidfluid overload
Mild to moderate haemophilia and von Willebrand’s
disease
▶BY INTRANASAL ADMINISTRATION
▶Child 1–17 years: 4 micrograms/kg for 1 dose, for pre-
operative use give 2 hours before procedure
▶BY INTRAVENOUS INFUSION, OR BY SUBCUTANEOUS INJECTION
▶Child: 300 nanograms/kg for 1 dose, to be administered
immediately before surgery or after trauma; may be
repeated at intervals of 12 hours if no tachycardia
Fibrinolytic response testing
▶BY SUBCUTANEOUS INJECTION, OR BY INTRAVENOUS INJECTION
▶Child 2–17 years: 300 nanograms/kg for 1 dose, blood to
be sampled after 20 minutes forfibrinolytic activity
Assessment of antidiuretic hormone secretion (congenital
deficiency suspected) (specialist use only)
▶BY INTRANASAL ADMINISTRATION
▶Child 1–23 months:Initially 100 – 500 nanograms for
1 dose
Assessment of antidiuretic hormone secretion (congenital
deficiency not suspected) (specialist use only)
▶BY INTRANASAL ADMINISTRATION
▶Child 1–23 months: 1 – 5 micrograms for 1 doselUNLICENSED USEConsult product literature for individual
preparations. Not licensed for assessment of antidiuretic
hormone secretion. Oral use ofDDAVPintravenous
injection is not licensed.
lCONTRA-INDICATIONSCardiac insufficiency.conditions
treated with diuretics.history of hyponatraemia.
polydipsia in alcohol dependence.psychogenic polydipsia
lCAUTIONS
GENERAL CAUTIONSAsthma.avoidfluid overload.
cardiovascular disease (not indicated for nocturnal
enuresis or nocturia).conditions which might be
aggravated by water retention.cysticfibrosis.epilepsy.
heart failure.hypertension (not indicated for nocturnal
enuresis or nocturia).migraine.nocturia—limitfluid
intake to minimum from 1 hour before dose until 8 hours
afterwards.nocturnal enuresis—limitfluid intake to
minimum from 1 hour before dose until 8 hours afterwards
SPECIFIC CAUTIONS
▶With intranasal useshould not be given intranasally for
nocturnal enuresis due to an increased incidence of side-
effects
lINTERACTIONS→Appendix 1 : desmopressin
lSIDE-EFFECTS
GENERAL SIDE-EFFECTS
▶Common or very commonHyponatraemia (on
administration without restrictingfluid intake).nausea
▶Frequency not knownAbdominal pain.aggression.allergic
dermatitis.emotional disorder.fluid retention.headache
.hyponatraemic seizure.vomiting.weight increased
SPECIFIC SIDE-EFFECTS
▶With intranasal useEpistaxis.nasal congestion.rhinitis
SIDE-EFFECTS, FURTHER INFORMATIONManufacturer
advises avoiding concomitant use of drugs which increaseBNFC 2018 – 2019 Diabetes insipidus 433
Endocrine system6