Active Ingredient: Desmopressin
For this indication, competent medicine agencies globally authorize below treatments:
For:
Intrasinal, between 10 micrograms desmopressin per kilogram of body weight and 40 micrograms desmopressin per kilogram of body weight, at morning, one dose.
| Weight | Intranasal dose |
|---|---|
| <10 kg | 10 micrograms |
| 10-30 kg | 20 micrograms |
| 30-50 kg | 30 micrograms |
| >50 kg | 40 micrograms |
The test serves both to distinguish diabetes insipidus from polyurias of other aetiology and to determine reduced renal concentrating capacity due to urinary tract infections as well as for early diagnosis of tubulo-interstitial damage e.g. due to lithium, analgesics, chemotherapeutics or immunosuppressants.
The desmopressin test is carried out preferably in the morning. Fluid intake should be restricted from 1 hour before to 8 hours after administration of the medicinal product. Children under 5 years old and patients with cardiovascular diseases or hypertension should reduce their fluid intake to 50%. It is recommended that the bladder should be emptied at the time of the administration.
Urine osmolality should be determined before and twice after administration of desmopressin. Urine collected within the first hour should be discarded. Urine osmolality is determined in the two subsequent urine samples, preferentially taken two and four hours after administration of desmopressin. In order to determine the renal concentrating capacity, the higher value is compared to the baseline value or to an age-specific reference value.
A substantial rise in urine osmolality along with a significant decrease in urine volume is indicative of central diabetes insipidus. Low values, absence of a rise or only a slight rise in urinary osmolality indicate reduced renal concentrating capacity.
The safety and efficacy of desmopressin in specific patient populations (with renal or hepatic impairments or other concomitant diseases) has not been investigated.
For:
Regimen A: Subcutaneous, 2 micrograms desmopressin, one dose.
Regimen B: Intramuscular, 2 micrograms desmopressin, one dose.
Adults and children can be expected to achieve urine concentrations above 700mOsm/kg in the period of 5 to 9 hours following a dose of 2 micrograms desmopressin injection. It is recommended that the bladder should be emptied at the time of administration.
For:
Regimen A: Subcutaneous, 0.4 micrograms desmopressin, one dose.
Regimen B: Intramuscular, 0.4 micrograms desmopressin, one dose.
In normal infants, a urine concentration of 600mOsm/kg should be achieved in the five hour period following a dose of 0.4 micrograms desmopressin injection. The fluid intake at the two meals following the administration should be restricted to 50% of the ordinary intake to avoid water overload.
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