desmopressin (nasal)

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Pronunciation: DEZ mo press in

Brand: DDAVP Nasal, DDAVP Rhinal Tube, Stimate

What is the most important information I should know about desmopressin nasal?

You should not use this medicine if you have ever had hyponatremia (low sodium levels in your body).

You may not be able to use desmopressin nasal if you have uncontrolled high blood pressure, severe heart failure, severe kidney disease, a condition called SIADH (syndrome of inappropriate antidiuretic hormone secretion), or any condition that causes excessive thirst, dehydration, or an electrolyte imbalance.

Call your doctor right away if you have signs of low sodium: headache, confusion, muscle cramps, severe weakness, vomiting, loss of coordination, and feeling restless or unsteady.

Serious drug interactions can occur when certain medicines are used together. Tell your doctor if you also use a "loop" diuretic or an inhaled steroid medicine.

Limit your intake of water and other fluids while you are using desmopressin. Drinking too much water can cause your body to lose sodium, which may lead to a serious, life-threatening electrolyte imbalance.

What is desmopressin nasal?

Desmopressin is a man-made form of a hormone that occurs naturally in the pituitary gland. This hormone is important for many functions including blood flow, blood pressure, kidney function, and regulating how the body uses water.

Desmopressin nasal is used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma.

The Stimate brand of desmopressin is used to treat bleeding episodes in people with hemophilia A or von Willebrand's disease Type I.

The Noctiva brand of desmopressin is used to treat excessive night-time urination in adults who are at least 50 years old. Noctiva should not be used to treat night-time bedwetting.

Desmopressin nasal may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using desmopressin nasal?

You should not use this medicine if you are allergic to desmopressin.

Depending on your condition, you may not be able to use desmopressin nasal if:

  • you have ever had hyponatremia (low sodium levels in your body);
  • you have uncontrolled high blood pressure;
  • you have severe heart failure;
  • you have severe kidney disease;
  • you have SIADH (syndrome of inappropriate antidiuretic hormone secretion (SIADH); or
  • you have an illness or condition that causes excessive thirst, dehydration, or an electrolyte imbalance.

Some medicines can cause unwanted or dangerous effects when used with desmopressin. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • a "loop" diuretic --bumetanide, ethacrynic acid, furosemide, torsemide; or
  • an inhaled steroid --beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone, mometasone, Arnuity Ellipta, Asmanex, Flovent, Pulmicort, Qvar, and others.

To make sure desmopressin nasal is safe for you, tell your doctor if you have:

  • an electrolyte imbalance;
  • a psychologic disorder that causes extreme or unusual thirst;
  • fluid retention;
  • congestive heart failure, coronary artery disease;
  • urination problems;
  • kidney disease;
  • an infection or illness with fever, vomiting, or diarrhea;
  • cystic fibrosis;
  • a head injury or brain tumor;
  • nasal problems such as a runny or stuffy nose;
  • diabetes; or
  • a history of blood clots, stroke, or heart attack.

Desmopressin nasal may be less effective if you have any swelling or scarring inside your nose, or any nasal or sinus problems (such as deviated septum).

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Desmopressin nasal should not be used to treat excessive urination that is a normal condition of pregnancy.

Desmopressin nasal can pass into breast milk, but effects on the nursing baby are not known. Tell your doctor if you are breast-feeding.

Do not give this medicine to a child without medical advice. Stimate is not approved for use by anyone younger than 11 years old. The use of Noctiva has not been studied in anyone younger than 50 years old.

How should I use desmopressin nasal?

Your doctor may perform urine tests to make sure desmopressin nasal is the right medicine for you.

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Prime the nasal spray before your first use. Pump 4 to 5 test sprays into the air, away from your face. You may need to prime the spray again whenever it has not been used in longer than 3 days.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Call your doctor if you have ongoing vomiting or diarrhea, fever, or if you are sweating more than usual. You can easily become dehydrated while taking this medicine, which can lead to severely low blood pressure or a serious electrolyte imbalance.

While using desmopressin, you may need frequent blood tests. Your doctor may change your dose based on the results of these tests. If you stop using desmopressin nasal for any length of time, you may need blood or urine tests before you restart the medicine.

Limit your intake of water and other fluids while you are using desmopressin. Drinking too much water can cause your body to lose sodium, which may lead to a serious, life-threatening electrolyte imbalance.

Fluid restriction is especially important in children and older adults using desmopressin nasal. Follow your doctor's instructions about the type and amount of liquids you should drink.

Store at room temperature away from moisture and heat. Keep the bottle in an upright position when not in use.

Store unopened Noctiva in the refrigerator. After the first use, keep the medicine at room temperature and use it within 60 days after opening. Keep the bottle in an upright position.

Store DDAVP Rhinal Tube in the refrigerator. Do not freeze. If refrigeration is not available, you may keep the closed bottles at room temperature for up to 3 weeks.

Throw away the spray bottle after you have used the specified number of sprays, even if there is medicine leftover in the bottle. Do not try to pour solution from one bottle to another. Do not use the medicine if the expiration date on the label has passed.

Keep track of how many sprays have been used from each bottle of desmopressin nasal spray. Each brand of this medicine contains a specific number of sprays per bottle. Your patient instructions may include a check-off chart to help you keep an accurate record of sprays used.

If you are treating hemophilia or von Willebrand's disease, get medical attention if your bleeding is not controlled during treatment with desmopressin nasal.

What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include headache, confusion, drowsiness, rapid weight gain, or urination problems.

What should I avoid while using desmopressin nasal?

To help prevent night-time urination, avoid drinking a lot of liquid close to bedtime.

What are the possible side effects of desmopressin nasal?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • low levels of sodium in the body --headache, confusion, hallucinations, muscle cramps, severe weakness, vomiting, loss of coordination, feeling restless or unsteady;
  • nasal problems --runny or stuffy nose, sinus congestion;
  • swelling in your feet or ankles;
  • a seizure (convulsions);
  • chest pain; or
  • pounding heartbeats or fluttering in your chest.

Common side effects may include:

  • stuffy nose, sneezing, nosebleeds, discomfort in your nose;
  • sore throat, cough, chest discomfort;
  • dizziness, drowsiness, feeling agitated;
  • increased blood pressure;
  • headache, back pain;
  • nausea, vomiting, stomach pain;
  • feeling hot or cold;
  • sleep problems (insomnia); or
  • eye itching or increased sensitivity to light.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect desmopressin nasal?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • any other nasal medicine;
  • an antidepressant;
  • bladder or urinary medicines;
  • cold or allergy medicine;
  • a diuretic or "water pill";
  • heart or blood pressure medication;
  • medicine to treat anxiety, mood disorders, bipolar disorder, or schizophrenia;
  • a steroid medicine;
  • seizure medicine --carbamazepine, lamotrigine; or
  • NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with desmopressin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about desmopressin nasal.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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