Desmopressin (Nasal Route)

Brand Name:

DDAVP, DDAVP Rhinal Tube, Minirin, and Stimate

Intranasal desmopressin is a synthetic form of ADH that is indicated for the treatment of central cranial diabetes insipidus. This condition causes excessive fluid loss that could lead to dehydration. Intranasal desmopressin is also used to manage frequent urination and increased thirst. 

A particular brand of intranasal desmopressin, Stimate®, is used particularly to treat bleeding in von Willebrand disease (Type I) or hemophilia A patients. It decreases urine flow as it mimics the action of natural ADH. 

In bleeding cases, this medicine increases the levels of factor VIII and von Willebrand factor in the blood. Intranasal desmopressin is only available with a prescription. It is sold as a solution.

Before starting treatment with intranasal desmopressin, you and your healthcare provider need to talk about the associated risks and benefits. You must also consider a number of factors that can influence the effectiveness of this medicine. You should not use intranasal desmopressin if you’ve had allergic reactions to it before. 

You also need to inform your doctor if you have allergies to food, preservatives, dyes, animals or other medications. Research has shown that intranasal desmopressin does not cause specific problems in children ages 3 years and older who have diabetes insipidus. Research has also found that Stimate® is safe to use in children 11 months of age and older who have hemophilia A or von Willebrand disease. 

Although adequate studies have found that intranasal desmopressin is safe to use in geriatric patients, caution should still be exercised since these patients could have age-related kidney problems. Intranasal desmopressin has a pregnancy category of B which means that it does not cause harmful effects on the fetus. 

This medication also poses little risk to breastfeeding babies. Consult your physician first before you take any kind of supplement or over-the-counter medication. This medicine can affect certain medical conditions. 

Inform your doctor if you have the following: 

• hypertension
• hypotension
• blood clotting problems
• tachycardia
• cystic fibrosis
• coronary artery disease
• heart failure
• kidney problems
• hyponatremia
• polydipsia
• moderate to severe kidney disease, and 
• type IIB von Willebrand disease

Follow the instructions given to you by your physician. If there’s something that’s not clear to you, do not hesitate to ask your healthcare provider. Please read the patient information sheet as well. You may be directed by your doctor to restrict fluid intake. 

Ask your nurse or doctor to demonstrate how to use the nasal spray. Prime the spray if this is your first time using it. You do this by pumping 4 times. Blow your nose gently before administering the medication. When you’re ready to take the medicine, tilt your head back and insert the nose piece into your nostril. 

Pump one spray into the nose while you inhale all the while closing the other nostril with your finger. Shortly hold your breath and then slowly breathe out through your mouth. Wipe the nose piece tip and replace the cap. The dose will depend on the condition. 

For adults and teenagers with diabetes insipidus, the dose is usually 0.1 to 0.4 mL. It can be taken as a single dose or divided up to 3 doses daily. Pediatric patients ages 3 months to 12 years should be given 0.05 to 0.3 mL. 

Again, this can be given as a single dose or divided up to 3 doses daily. For adults and teenagers with hemophilia A or won Willebrand disease, the dose usually is one spray per nostril daily. Do not double dose. Keep your medication away from the reach of children.

You need to go to your follow-up appointments religiously so that your physician can monitor your progress and prevent side effects. You also need to get regular blood work and other lab exams. Watch out for signs of low sodium, which include nausea, vomiting, confusion, muscle cramps, or unusual tiredness. 

Check with your physician if you have those signs. In rare cases, intranasal desmopressin can cause anaphylaxis which is a severe allergic reaction. Get medical help right away if you have itching, trouble breathing, chest pain, rashes, or swelling of the face, tongue, and throat. Again, do not use any over-the-counter medicine without consulting your physician first.

Intranasal desmopressin can have several side effects. However, you may not develop any of them. Even though instances are rare, you should consult your doctor right away if you have the following: 

• chills
• difficulty swallowing
• confusion
• convulsions
• dizziness
• cough
• drowsiness
• fever
• trouble breathing
• puffiness or swelling of the eyelids or around the eyes
• tightness in the chest
• unusual tiredness/weakness or skin rash
• hives, or itching

Common side effects that may not need treatment include runny nose, sneezing, bloody nose, diarrhea, eye discharge or excessive tearing, loss of appetite, indigestion, passing gas, stomach pain, or redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid. If symptoms get worse, consult your doctor.