secretion of vasopressin (e.g. tricyclic antidepressants)—
increases risk of hyponatraemia.
lPREGNANCYSmall oxytocic effect in third trimester;
increased risk of pre-eclampsia.
lBREAST FEEDINGAmount too small to be harmful.
lRENAL IMPAIRMENTUse with caution; antidiuretic effect
may be reduced.
lMONITORING REQUIREMENTSInnocturia, periodic blood
pressure and weight checks are needed to monitor forfluid
overload.
lDIRECTIONS FOR ADMINISTRATIONDDAVP®and
Desmotabs®tablets may be crushed.
DDAVP®intranasal solution may be diluted with
Sodium Chloride 0. 9 % to a concentration of
10 micrograms/mL.
DDAVP®injection may be administered orally.
Desmopressin oral lyophilisates are for sublingual
administration.
▶With intravenous useHigher doses ofDDAVP®by
intravenous infusion, used in mild to moderate haemophilia
and von Willebrand’s disease, may be diluted with
30 – 50 mL Sodium Chloride 0. 9 % intravenous infusion.
Forintravenous infusion(Octim®), dilute with 50 mL of
Sodium Chloride 0. 9 % and give over 20 minutes.
lPRESCRIBING AND DISPENSING INFORMATIONOral,
intranasal, intravenous, subcutaneous and intramuscular
doses are expressed as desmopressin acetate; sublingual
doses are expressed as desmopressin base.
Children requiring an intranasal dose of less than
10 micrograms should be givenDDAVP®intranasal
solution.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Desmopressin for bedwetting
http://www.medicinesforchildren.org.uk/desmopressin-bedwetting- 0
Hyponatraemic convulsionsPatients being treated for
primary nocturnal enuresis should be warned to avoidfluid
overload (including during swimming) and to stop taking
desmopressin during an episode of vomiting or diarrhoea
(untilfluid balance normal).lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: capsule, oral suspension, oral solution,
spray, nasal drops
Tablet
▶Desmopressin (Non-proprietary)
Desmopressin acetate 100 microgramDesmopressin
100 microgram tablets| 90 tabletP£ 76. 62 DT = £ 63. 08
Desmopressin acetate 200 microgramDesmopressin
200 microgram tablets| 30 tabletP£ 35. 23 DT = £ 9. 09
▶DDAVP(Ferring Pharmaceuticals Ltd)
Desmopressin acetate 100 microgramDDAVP 0. 1 mg tablets|
90 tabletP£ 44. 12 DT = £ 63. 08
Desmopressin acetate 200 microgramDDAVP 0. 2 mg tablets|
90 tabletP£ 88. 23
▶Desmotabs(Ferring Pharmaceuticals Ltd)
Desmopressin acetate 200 microgramDesmotabs 0. 2 mg tablets|
30 tabletP£ 29. 43 DT = £ 9. 09
Solution for injection
▶DDAVP(Ferring Pharmaceuticals Ltd)
Desmopressin acetate 4 microgram per 1 mlDDAVP
4 micrograms/ 1 ml solution for injection ampoules| 10 ampouleP
£ 13. 16
▶Octim(Ferring Pharmaceuticals Ltd)
Desmopressin acetate 15 microgram per 1 mlOctim
15 micrograms/ 1 ml solution for injection ampoules|
10 ampouleP£ 192. 20
Spray
▶Desmopressin (Non-proprietary)
Desmopressin acetate 10 microgram per 1 doseDesmopressin
10 micrograms/dose nasal spray| 60 doseP£ 31. 50 DT = £ 28. 06▶Desmospray(Ferring Pharmaceuticals Ltd)
Desmopressin acetate 2.5 microgram per 1 doseDesmospray
2. 5 micrograms/dose nasal spray| 50 doses
Desmopressin acetate 10 microgram per 1 doseDesmospray
10 micrograms/dose nasal spray| 60 doseP£ 25. 02 DT = £ 28. 06
▶Octim(Ferring Pharmaceuticals Ltd)
Desmopressin acetate 150 microgram per 1 doseOctim
150 micrograms/dose nasal spray| 25 doseP£ 576. 60
Oral lyophilisate
CAUTIONARY AND ADVISORY LABELS 26
▶DDAVP Melt(Ferring Pharmaceuticals Ltd)
Desmopressin (as Desmopressin acetate) 60 microgramDDAVP
Melt 60 microgram oral lyophilisates sugar-free| 100 tabletP
£ 50. 53 DT = £ 50. 53
Desmopressin (as Desmopressin acetate) 120 microgramDDAVP
Melt 120 microgram oral lyophilisates sugar-free| 100 tabletP
£ 101. 07 DT = £ 101. 07
Desmopressin (as Desmopressin acetate) 240 microgramDDAVP
Melt 240 microgram oral lyophilisates sugar-free| 100 tabletP
£ 202. 14
▶DesmoMelt(Ferring Pharmaceuticals Ltd)
Desmopressin (as Desmopressin acetate)
120 microgramDesmoMelt 120 microgram oral lyophilisates sugar-
free| 30 tabletP£ 30. 34 DT = £ 30. 34
Desmopressin (as Desmopressin acetate)
240 microgramDesmoMelt 240 microgram oral lyophilisates sugar-
free| 30 tabletP£ 60. 68 DT = £ 60. 68
▶Noqdirna(Ferring Pharmaceuticals Ltd)
Desmopressin (as Desmopressin acetate) 25 microgramNoqdirna
25 microgram oral lyophilisates sugar-free| 30 tabletP£ 15. 16 DT
=£ 15. 16
Desmopressin (as Desmopressin acetate)
50 microgramNoqdirna 50 microgram oral lyophilisates sugar-free
| 30 tabletP£ 15. 16 DT = £ 15. 16
Nasal drops
▶DDAVP(Ferring Pharmaceuticals Ltd)
Desmopressin acetate 100 microgram per 1 mlDDAVP
100 micrograms/ml intranasal solution| 2. 5 mlP£ 9. 72 DT = £ 9. 722 Corticosteroid responsive
conditions
CORTICOSTEROIDS
Corticosteroids, general use
Overview
Dosages of corticosteroids vary widely in different diseases
and in different patients. If the use of a corticosteroid can
save or prolong life, as in exfoliative dermatitis, pemphigus,
acute leukaemia or acute transplant rejection, high doses
may need to be given, because the complications of therapy
are likely to be less serious than the effects of the disease
itself.
When long-term corticosteroid therapy is used in some
chronic diseases, the adverse effects of treatment may
become greater than the disabilities caused by the disease.
To minimise side-effects the maintenance dose should be
kept as low as possible.
When potentially less harmful measures are ineffective
corticosteroids are used topically for the treatment of
inflammatory conditions of the skin. Corticosteroids should
be avoided or used only under specialist supervision in
psoriasis.
Corticosteroids are used both topically (by rectum) and
systemically (by mouth or intravenously) in the management
of ulcerative colitis and Crohn’s disease.
Use can be made of the mineralocorticoid activity of
fludrocortisone acetate p. 440 to treat postural hypotension
in autonomic neuropathy.
High-dose corticosteroids should be avoided for the
management of septic shock. However, low-dose434 Corticosteroid responsive conditions BNFC 2018 – 2019
Endocrine system6