Wednesday, December 17, 2014

Desmopressin (DDAVP®)

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Overview


  • Water balance in the body is controlled by the amount of water consumed relative to the amount lost in the intestines, sweat and urine. The kidney is ultimately responsible for controlling water balance in the body. 
  • Control of kidney function comes from nerves and hormones. One of these hormones,antidiuretic hormone or ADH, plays a key role by allowing the kidney to control water loss in the urine. 
  • Another function of ADH is constriction of blood vessels to raise blood pressure. This has lead to a second name for this hormone – vasopressin. 
  • Desmopressin is a synthetic vasopressin.
  • Desmopressin acetate is used for replacement of deficient ADH.
  • Another effect of desmopressin is a transient increase in certain blood clotting factors.
  • Desmopressin is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.

    Brand Names and Other Names

  • This drug is registered for use in humans only.
  • Human formulations: DDAVP® (Rhone-Poulenc Rorer)
  • Veterinary formulations: None

    Uses of Desmopressin

  • Desmopressin is used in the treatment of central diabetes insipidus in dogs and cats.
  • An unusual application of this drug is in the therapy of von Willebrand's disease, a blood clotting problem commonly found in dogs. This is a genetic disorder involving clotting proteins (factors) and the blood platelet. 

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, desmopressin can cause side effects in some animals.
  • Desmopressin should not be used in animals with known hypersensitivity or allergy to the drug.
  • Desmopressin may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with desmopressin. Such drugs include epinephrine, heparin,and fludrocortisone.
  • Desmopressin can cause conjunctival irritation (inflammation) of the eyes after administration in some patients.
  • Fluid retention can also occur following high doses of desmopressin.

    How Desmopressin Is Supplied

  • Desmopressin is available as a nasal solution, solution for injection and tablet form.
  • Nasal solution: 10 micrograms/0.1 ml in 2.5 or 5 ml bottles
  • Injectable form: 4 micrograms/ml, 1 ml or 10 ml bottles.
  • Tablet form: 0.1 and 0.2 mg tablets

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian. 
  • DDAVP nasal drops are administered into the eye or into the nose. The latter approach can be difficult in some pets.
  • The dose for desmopressin is one to two drops of the nasal spray administered in the conjunctival sac (eyes) or in each nostril once or twice daily.
  • Desmopressin can also be given as a subcutaneous injection. The dose is 1 to 2 mcg per dog for central diabetes insipidus.
  • For von Willebrand's disease, desmopressin is dosed at 0.5 mcg per pound (1 mcg/kg) subcutaneously as needed. The effect of the drug generally lasts for about 4 hours.
  • There is no injectable dose available for cats.
  • Unfortunately, this treatment is not cost effective, as the drug is very expensive. 
  • Life-term therapy is needed for treatment of central diabetes insipidus. 
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.
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